HEPATITIS PROFILE, ACUTE, SERUM, REFLEX HCV RNA VIRAL LOAD

Additional Codes

Software	Test Code
Label Text	ACHPR
EPIC	LAB20072

Performing Laboratory

NorDx Laboratories

Useful For

Differential diagnosis of acute viral hepatitis. “Hepatitis B Surface Antigen Confirmation, Serum” may be performed at an additional charge on specimens exhibiting low positivity for Hepatitis B Surface Antigen.

Includes: Hepatitis B Core Antibody (IgM), Hepatitis A Antibody (IgM), Hepatitis C Antibody, Hepatitis B Surface Antigen and HCVVL if indicated.

Method Name

Chemiluminescent Immunoassay (CIA)

Reverse Transcription-Polymerase Chain Reaction (RT-PCR)

Reference Values

Negative

Results reported as positive, negative or equivocal.

Positive or equivocal Hepatitis C Antibody result will reflex to Hepatitis C Virus RNA Viral Load.

Interpretation depends on clinical setting.

Days and Times Test Performed

Monday through Friday

Report Available

1 Day

Profile Information

Individual Test Description
HEPATITIS A VIRUS ANTIBODY, IgM (ANTI-HAV, IgM), SERUM
HEPATITIS B CORE ANTIBODY, IgM, SERUM
HEPATITIS B SURFACE ANTIGEN, SERUM
HEPATITIS C AB DIAGNOSTIC REFLEX HCVVL

Specimen Type

Serum

Preferred Container

2 x Serum Separator Tube (SST)

Preferred Volume

Serum: 2 mL (Serum Separator Tube (SST))

Minimum Volume

Serum: 1.5 mL (Serum Separator Tube (SST))

Specimen Collection and Handling

Spin specimens, separate from clot and send:

one refrigerated (label .1)
one frozen (label .2) aliquot

Specimen Stability Information

Specimen Type: Serum

Frozen: 3 Months

Refrigerated: 5 Days

Must be spun/separated within: 2 Hours

Add On Capable

Yes

Advance Beneficiary Notice Requirements

This test, when ordered on Medicare patients, is subject to the National Coverage Determination (NCD) policies. Please verify that the diagnosis code (ICD code) you have chosen demonstrates medical necessity for the test as documented in the physician’s patient record. The CMS web site is available to assist you with this verification. A properly executed Advance Beneficiary Notice (ABN) must be submitted with the specimen if medical necessity is not demonstrated by the ICD code chosen.

CPT Code Information

CPT Code	CPT Description	CPT Disclaimer
80074	Acute Hepatitis Panel
87341	Infectious Agent Antigen Detection by Immunoassay Technique, Qualitative or Semiquantitative, Multiple-Step Method, Hepatitis B Surface Antigen (HBsAg) Neutralization
87522	Infectious Agent Detection by Nucleic Acid (DNA or RNA), Hepatitis C Virus, Quantification, Includes Reverse Transcription when Performed

Performing Laboratory Location