HIV-1/2 Antigen and Antibodies, Fourth Generation, with Reflexes

HIV-1/2 Antigen and Antibodies, Fourth Generation, with Reflexes

Test Code

91431
87389
CPT Code is subject to a Medicare Limited Coverage Policy and may require a signed ABN when ordering.
91431
87389
CPT Code is subject to a Medicare Limited Coverage Policy and may require a signed ABN when ordering.
In-home collection may be available in your area for purchase through Quest Mobile.

Clinical Significance

HIV-1/2 Antigen and Antibodies, Fourth Generation, with Reflexes - This algorithm is used to help diagnose HIV-1 and HIV-2 infection, including acute infection, and to differentiate HIV-1 from HIV-2. It is consistent with the HIV diagnostic algorithm recommended by the Centers for Disease Control and Prevention [2]. It can be used in adults, including pregnant women, and in children 2 years or older.

This panel begins with an antigen/antibody assay that allows for detection of acute HIV-1 infection based on the presence of p24 antigen before seroconversion occurs, and HIV-1 and HIV-2 antibodies post-seroconversion. If the HIV-1/HIV-2 antigen/antibody test ...

Test Details

Includes

  • If HIV Antigen and Antibody, 4th Generation Screen is Reactive, then HIV-1/2 Antibody Differentiation will be performed at an additional charge (CPT code(s): 86701, 86702).

    If HIV-1/2 Antibody Differentiation is Indeterminate or Negative, then HIV-1 and HIV-2 RNA, Qualitative Real-Time PCR will be performed at an additional charge (CPT code(s): 87535, 87538).

Methodology

Immunoassay (IA)

Reference Range(s)

HIV Final InterpretationSee Laboratory Report
HIV Ag/Ab, 4th GenNon-Reactive

Alternative Name(s)

Fourth Generation HIV,4th Generation HIV

LOINC® Codes, Performing Laboratory

If HIV Antigen and Antibody, 4th Generation Screen is Reactive, then HIV-1/2 Antibody Differentiation will be performed at an additional charge (CPT code(s): 86701, 86702).

If HIV-1/2 Antibody Differentiation is Indeterminate or Negative, then HIV-1 and HIV-2 RNA, Qualitative Real-Time PCR will be performed at an additional charge (CPT code(s): 87535, 87538).

Methodology

Immunoassay (IA)

Reference Range(s)

HIV Final InterpretationSee Laboratory Report
HIV Ag/Ab, 4th GenNon-Reactive

Alternative Name(s)

Fourth Generation HIV,4th Generation HIV

Preferred Specimen(s)

3 mL serum

Alternative Specimen(s)

Serum collected in: Red-top tube (no gel) • Plasma collected in: EDTA (lavender-top) tube

Minimum Volume

2 mL

Collection Instructions

⁠⁠⁠⁠⁠⁠⁠Serum: Collect in a serum separator tube or red-top tube (no gel). The tube should be centrifuged after clotting. Spun serum separator tubes may be submitted at room temperature or refrigerated unopened without transfer to a plastic screw-cap vial. Red-top tube (no gel) serum should be transferred to a plastic screw-cap vial and submitted for testing.

Plasma: Collect in an EDTA (lavender-top) tube and centrifuge tube within 24 hours of collection. Transfer plasma to a plastic screw-cap vial, label as plasma, and submit for testing.

Submitted tubes must be labeled with patient identifier and submitted only for HIV testing.

Transport Container

Serum separator tube (SST)
Submitted tubes must be labeled with patient identifier and submitted only for HIV testing.

Transport Temperature

Room temperature

Specimen Stability

  • Room temperature: 72 hours
  • Refrigerated: 5 days
  • Frozen: 30 days

Reject Criteria

Gross hemolysis • Frozen serum separator tube (SST)

Setup Schedule

3 mL serum
Serum collected in: Red-top tube (no gel) • Plasma collected in: EDTA (lavender-top) tube
2 mL
⁠⁠⁠⁠⁠⁠⁠Serum: Collect in a serum separator tube or red-top tube (no gel). The tube should be centrifuged after clotting. Spun serum separator tubes may be submitted at room temperature or refrigerated unopened without transfer to a plastic screw-cap vial. Red-top tube (no gel) serum should be transferred to a plastic screw-cap vial and submitted for testing.

Plasma: Collect in an EDTA (lavender-top) tube and centrifuge tube within 24 hours of collection. Transfer plasma to a plastic screw-cap vial, label as plasma, and submit for testing.

Submitted tubes must be labeled with patient identifier and submitted only for HIV testing.
Serum separator tube (SST)
Submitted tubes must be labeled with patient identifier and submitted only for HIV testing.
Room temperature
Room temperature: 72 hours
Refrigerated: 5 days
Frozen: 30 days
Gross hemolysis • Frozen serum separator tube (SST)
In-home collection may be available in your area for purchase through Quest Mobile.
Test Details

Clinical Significance

Test Resources

Reference ranges are provided as general guidance only. To interpret test results use the reference range in the laboratory report.

The CPT codes provided are based on AMA guidance and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

This material contains content from LOINC® (http://loinc.org). The LOINC Table, LOINC Table Core are copyright © 1995-2019, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license at http://loinc.org/license.

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