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Image-Guided Pap with Age-Based Screening Protocols
Test Code91384
CPT Codes
88175*<br><strong>*</strong>See below for age related testing and CPT codes<br><strong>This test is not available for California patient testing.</strong>
Includes
Patients aged 21-24: If the Pap result is ASC-US then the HPV mRNA assay will be performed at an additional charge (CPT code(s): 87624). Chlamydia trachomatis (CT)/Neisseria gonorrhoeae (NG) RNA, TMA will also be performed (CPT code(s): 87491, 87591).
Patients aged 25-29: If the Pap result is ASC-US then the HPV mRNA assay will be performed at an additional charge (CPT code(s): 87624).
Patients aged 30-65: If the Pap result is negative and the HPV mRNA screen (CPT code(s): 87624) is positive (detected), then HPV mRNA Genotypes 16, 18/45 will be performed at an additional charge (CPT code(s): 87625).
Pap results requiring physician interpretation will be performed at an additional charge (CPT Code(s): 88141; HCPCS: G0124).
Patients aged 25-29: If the Pap result is ASC-US then the HPV mRNA assay will be performed at an additional charge (CPT code(s): 87624).
Patients aged 30-65: If the Pap result is negative and the HPV mRNA screen (CPT code(s): 87624) is positive (detected), then HPV mRNA Genotypes 16, 18/45 will be performed at an additional charge (CPT code(s): 87625).
Pap results requiring physician interpretation will be performed at an additional charge (CPT Code(s): 88141; HCPCS: G0124).
Preferred Specimen
Pap sample collected in 1 ThinPrep® pap vial or pap sample collected in 1 SurePath™ pap vial
Minimum Volume
1 ThinPrep pap vial • 1 SurePath pap vial
Instructions
For instructions refer to
//www.questdiagnostics.com/dms/Documents/Other/Specimen_Collection_and_Transport_Guide_2019.pdf
//www.questdiagnostics.com/dms/Documents/Other/Specimen_Collection_and_Transport_Guide_2019.pdf
Transport Container
1 ThinPrep pap vial or 1 SurePath pap vial
Transport Temperature
Room temperature
Specimen Stability
SurePath Pap - SurePath Pap Vial
Room Temperature: 28 days
Refrigerated: 6 months
Frozen: Unacceptable
SurePath HPV - SurePath Pap Vial
Room temperature: 7 days
Refrigerated: 7 days
Frozen: Unacceptable
SurePath HPV - SurePath Preservative Fluid in Aptima® Transfer Tube
Room temperature: 7 days
Refrigerated: 7 days
Frozen: Unacceptable
SurePath CT/NG - SurePath Pap Vial
Room temperature: 4 days
Refrigerated: Unacceptable
Frozen: Unacceptable
SurePath CT/NG - SurePath Preservative Fluid in Aptima® Transfer Tube
Room temperature: 14 days
Refrigerated: 14 days
Frozen: Unacceptable
ThinPrep Pap
Room temperature: 42 days
Refrigerated: Unacceptable
Frozen: Unacceptable
HPV - ThinPrep Pap Vial
Room temperature: 30 days
Refrigerated: 105 days
Frozen: Unacceptable
ThinPrep Pap Vial in Aptima® Transfer Tube
Room temperature: 60 days
Refrigerated: 60 days
Frozen: 2 years
CT/NG - ThinPrep Pap Vial
Room temperature: 30 days
Refrigerated: 30 days
Frozen: Unacceptable
CT/NG - ThinPrep Pap Vial in Aptima® Transfer Tube
Room temperature: 14 days
Refrigerated: 30 days
Frozen: 1 year
Refer to local service area for specimen retention.
Room Temperature: 28 days
Refrigerated: 6 months
Frozen: Unacceptable
SurePath HPV - SurePath Pap Vial
Room temperature: 7 days
Refrigerated: 7 days
Frozen: Unacceptable
SurePath HPV - SurePath Preservative Fluid in Aptima® Transfer Tube
Room temperature: 7 days
Refrigerated: 7 days
Frozen: Unacceptable
SurePath CT/NG - SurePath Pap Vial
Room temperature: 4 days
Refrigerated: Unacceptable
Frozen: Unacceptable
SurePath CT/NG - SurePath Preservative Fluid in Aptima® Transfer Tube
Room temperature: 14 days
Refrigerated: 14 days
Frozen: Unacceptable
ThinPrep Pap
Room temperature: 42 days
Refrigerated: Unacceptable
Frozen: Unacceptable
HPV - ThinPrep Pap Vial
Room temperature: 30 days
Refrigerated: 105 days
Frozen: Unacceptable
ThinPrep Pap Vial in Aptima® Transfer Tube
Room temperature: 60 days
Refrigerated: 60 days
Frozen: 2 years
CT/NG - ThinPrep Pap Vial
Room temperature: 30 days
Refrigerated: 30 days
Frozen: Unacceptable
CT/NG - ThinPrep Pap Vial in Aptima® Transfer Tube
Room temperature: 14 days
Refrigerated: 30 days
Frozen: 1 year
Refer to local service area for specimen retention.
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
ThinPrep vials received refrigerated or frozen • Swabs • Cervical swabs in Digene® HC cervical sampler • Digene® vials • SurePath vials without the head of the collection device(s) in the fluid • SurePath vials received frozen
Methodology
Pap: Microscopy with Computer-imaging
HPV/CT/NG: Transcription Mediated Amplification (TMA)
Setup Schedule
Set up: Mon-Sat; Report available: 5 days
Reference Range
See Laboratory Report
Clinical Significance
This new test code is designed to help clinicians order age-appropriate testing for cervical cancer screening and STIs. Based on the patient's age and on ACOG Practice Guidelines for cervical cancer screening and Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) screening, testing in addition to the Pap will be processed as follows:
• Patients aged 21-24: Patients will receive Image-guided Pap and, when the result is ASC-US, a high-risk HPV mRNA test will be performed. Additionally, testing for CT/NG will be performed.
• Patients aged 25-29: Patients will receive Image-guided Pap and, when the result is ASC-US, a high-risk HPV mRNA test will be performed.
• Patients aged 30-65: Patients will receive Image-guided Pap and a high-risk HPV mRNA test. When the Pap result is negative but the HPV mRNA screen is positive, Genotyping for HPV mRNA 16, 18/45 will be performed.
• Patients falling outside of the above age ranges, or without a date of birth, will receive an Image-guided Pap only.
Codes may include ThinPrep® or SurePath™ Image-guided Paps, HPV mRNA, CT/NG.
• Patients aged 21-24: Patients will receive Image-guided Pap and, when the result is ASC-US, a high-risk HPV mRNA test will be performed. Additionally, testing for CT/NG will be performed.
• Patients aged 25-29: Patients will receive Image-guided Pap and, when the result is ASC-US, a high-risk HPV mRNA test will be performed.
• Patients aged 30-65: Patients will receive Image-guided Pap and a high-risk HPV mRNA test. When the Pap result is negative but the HPV mRNA screen is positive, Genotyping for HPV mRNA 16, 18/45 will be performed.
• Patients falling outside of the above age ranges, or without a date of birth, will receive an Image-guided Pap only.
Codes may include ThinPrep® or SurePath™ Image-guided Paps, HPV mRNA, CT/NG.
Performing Laboratory
Quest Diagnostics Nichols Institute Chantilly
14225 Newbrook Dr
Chantilly, VA 20153