Hepatitis Panel, Acute with Reflex to Confirmation

Test Code

10306

CPT Codes
80074

Includes

Hepatitis A IgM Antibody
Hepatitis B Surface Antigen with Reflex to Confirmation
Hepatitis B Core Antibody (IgM)
Hepatitis C Antibody with Reflex to HCV, RNA, Quantitative, Real-Time PCR

Hepatitis B Surface Antigen: Positive samples will be confirmed based on the manufacturer's FDA approved recommendations at an additional charge (CPT code(s): 87341).
If Hepatitis C Antibody is reactive or borderline, then Hepatitis C Viral RNA, Quantitative, Real-Time PCR will be performed at an additional charge (CPT code(s): 87522).

Preferred Specimen

5 mL serum

Minimum Volume

2.5 mL

Instructions

Dietary supplements containing biotin may interfere in assays and may skew analyte results to be either falsely high or falsely low. For patients receiving the recommended daily doses of biotin, draw samples at least 8 hours following the last biotin supplementation. For patients on mega-doses of biotin supplements, draw samples at least 72 hours following the last biotin supplementation.

Transport Container

Transport tube

Transport Temperature

Refrigerated (cold packs)

Specimen Stability

Room temperature: 72 hours
Refrigerated: 14 days
Frozen: 21 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Gross hemolysis • Gross lipemia

Methodology
Immunoassay (IA)

Setup Schedule

Set up: Mon-Sat; Report available: Next day

Limitations

Results obtained from immunosuppressed patients should be interpreted with caution. Patients receiving mouse antibody therapy may produce false-negative results. False-positives may be detected shortly after immunization to influenza and with patients with hypergammaglobulinemia, positive rheumatoid factor, and connective tissue disorders.

Reference Range

See individual tests

Clinical Significance

This panel may be helpful in the diagnosis of acute or recent infection with hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis C virus (HCV), the 3 most common pathogens of viral hepatitis in the United States [1].

Acute symptoms and signs are similar among HAV, HBV, and HCV infection and may include fever, fatigue, loss of appetite, nausea, abdominal discomfort, dark urine, pale stools, and jaundice [1-4]. This panel may help establish diagnosis of these 3 viral hepatitis infections in symptomatic patients.

This panel includes 4 tests with reflexes: HAV IgM antibody, hepatitis B surface antigen (HBsAg) with reflex to confirmation, hepatitis B core IgM antibody (HBcAb IgM), and HCV antibody with reflex to HCV RNA quantitative real-time PCR.

The section below outlines the roles of the analytes assessed with this panel.

HAV IgM: Presence indicates current or recent infection or recent vaccination. A negative result indicates absence of acute infection [2].

HBsAg with reflex confirmation: Presence indicates that a person has a current HBV infection and is infectious [3].

HBcAb IgM: Presence indicates HBV infection within the preceding 4 to 6 months (ie, acute/recent infection) [3].

HCV antibody with reflex to HCV RNA: Presence (with detectable HCV RNA) indicates current infection. A positive result with a "not detected" HCV RNA reflex result may indicate a resolved infection or a biological false-positive antibody screening test [4].

The results of the test in the panel should be interpreted in the context of pertinent clinical history and physical examination findings.

References
1. Viral Hepatitis Surveillance - United States, 2019. Centers for Disease Control and Prevention. Accessed January 16, 2021. https://www.cdc.gov/hepatitis/statistics/2019surveillance/pdfs/2019HepSurveillanceRpt.pdf
2. Nelson NP, et al. MMWR Recomm Rep. 2020;69(5):1-38.
3. Roush SW, et al. Chapter 22: laboratory support for surveillance of vaccine-preventable diseases. In: Roush SW, et al, eds. Manual for the Surveillance of Vaccine-Preventable Diseases. Centers for Disease Control and Prevention. Reviewed June 3, 2021. Accessed January 16, 2022. https://www.cdc.gov/vaccines/pubs/surv-manual/chpt22-lab-support.html
4. Centers for Disease Control and Prevention. MMWR Morb Mortal Wkly Rep. 2013;62(18):362-365.

Performing Laboratory

Quest Diagnostics Nichols Institute

14225 Newbrook Drive

Chantilly, VA 20153

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.