Hepatitis C-Infected Patient, Baseline Panel 1

Hepatitis C-Infected Patient, Baseline Panel 1

Test Code

91704
80076, 85025, 82565, 86708, 87340, 86704, 87389, 87902, 86706
CPT Code is subject to a Medicare Limited Coverage Policy and may require a signed ABN when ordering.
91704
80076, 85025, 82565, 86708, 87340, 86704, 87389, 87902, 86706
CPT Code is subject to a Medicare Limited Coverage Policy and may require a signed ABN when ordering.
Not offered in Quest Nichols Institute - Chantilly, VA | Quest Diagnostics Nichols Institute (IFD) – San Juan Capistrano | Quest Nichols Institute -San Juan Capistrano, CA. Please provide SERVICE AREA INFORMATION to find available tests you can order.
In-home collection is not available in your area through Quest Mobile.

Clinical Significance

Hepatitis C-Infected Patient, Baseline Panel 1 - This panel is important to baseline the laboratory parameters in order to define change on therapy as well as to assess the risk of any underlying medical conditions prior to initiation of therapy for Hepatitis C.

Test Details

Includes

  • Hepatic Function Panel
    CBC (includes Differential and Platelets)
    Creatinine
    Hepatitis A Antibody, Total
    Hepatitis B Surface Antibody, Qualitative
    Hepatitis B Surface Antigen with Reflex Confirmation
    Hepatitis B Core Antibody, Total
    Hepatitis C Viral RNA, Genotype
    HIV-1/2 Antigen and Antibodies, Fourth Generation, with Reflexes

    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 HIV Antigen and Antibody, 4th Generation Screen is Repeatedly 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

See individual tests

Reference Range(s)

See individual tests

LOINC® Codes, Performing Laboratory

Hepatic Function Panel
CBC (includes Differential and Platelets)
Creatinine
Hepatitis A Antibody, Total
Hepatitis B Surface Antibody, Qualitative
Hepatitis B Surface Antigen with Reflex Confirmation
Hepatitis B Core Antibody, Total
Hepatitis C Viral RNA, Genotype
HIV-1/2 Antigen and Antibodies, Fourth Generation, with Reflexes

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 HIV Antigen and Antibody, 4th Generation Screen is Repeatedly 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

See individual tests

Reference Range(s)

See individual tests

Preferred Specimen(s)

Whole blood and serum and plasma - See Collection Instructions

Collection Instructions

Whole blood: 1 full EDTA (lavender-top) tube. Submit at room temperature.

Serum: 3 spun serum separator tubes (SST). Submit at room temperature and 1 spun serum separator tube (SST). Submit refrigerated.
Note: HIV submission must remain unopened.

Plasma: 2 mL plasma collected in a PPT potassium EDTA (white-top) tube or EDTA (lavender-top) tube.
Separate plasma from whole blood within 24 hours of collection by centrifugation at 800-1600 X G for 20 minutes at room temperature. Transfer the plasma to a properly identified, sterile, polypropylene transport tube and ship refrigerated or frozen.

Transport Container

See Collection Instructions

Transport Temperature

See Collection Instructions

Specimen Stability

  • See individual tests

Reject Criteria

See individual tests

Setup Schedule

Whole blood and serum and plasma - See Collection Instructions
Whole blood: 1 full EDTA (lavender-top) tube. Submit at room temperature.

Serum: 3 spun serum separator tubes (SST). Submit at room temperature and 1 spun serum separator tube (SST). Submit refrigerated.
Note: HIV submission must remain unopened.

Plasma: 2 mL plasma collected in a PPT potassium EDTA (white-top) tube or EDTA (lavender-top) tube.
Separate plasma from whole blood within 24 hours of collection by centrifugation at 800-1600 X G for 20 minutes at room temperature. Transfer the plasma to a properly identified, sterile, polypropylene transport tube and ship refrigerated or frozen.
See Collection Instructions
See Collection Instructions
See individual tests
See individual tests
Not offered in Quest Nichols Institute - Chantilly, VA | Quest Diagnostics Nichols Institute (IFD) – San Juan Capistrano | Quest Nichols Institute -San Juan Capistrano, CA. Please provide SERVICE AREA INFORMATION to find available tests you can order.
In-home collection is not available in your area 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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