Test Code HCVFS / 550123-LC HEPATITIS C VIRUS (HCV) FIBROSURE

Important Note

This test may require pre-authorization or have limited coverage. Please check with your appropriate insurance carrier to determine any specific requirements.

Additional Codes

Software	Test Code
SoftID	HCVFS
EPIC	LAB20445
LabCorp	550123

Performing Laboratory

Laboratory Corporation of America (LabCorp)

Useful For

Assessing liver status following a diagnosis of HCV; determining baseline of liver status before initiating HCV therapy; providing posttreatment assessment of liver status six months after completion of therapy; providing noninvasive assessment of liver status in patients who are at increased risk of complications from a liver biopsy

Method Name

Colorimetric Immunologic Kinetic-Colorimetric Nephelometry

Reference Values

An interpretive report will be issued

Days and Times Test Performed

Monday through Saturday

Report Available

3-5 Days

Analytic time for send out tests is the time it will take to perform testing once it has arrived at the performing reference lab. Please add 1 to 2 days from time of collection to allow for receipt at NorDx central lab and shipment of specimen, add another day if specimen is collected on the day before a weekend or holiday.

Specimen Type

Serum

Preferred Container

Serum Separator Tube (SST)

Preferred Volume

Serum: 3.5 mL (Serum Separator Tube (SST))

Minimum Volume

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

Specimen Collection and Handling

1. Spin specimen, separate from clot within 1 hour and send frozen.

2. Patient age and sex must be included on the test request form.

NOTE: Patient should be fasting for at least eight hours.

Specimen Stability Information

Specimen Type: Serum

Frozen: 7 Days

Refrigerated: 72 Hours

Room Temperature: 72 Hours

Note: Specimen can be stored refrigerated at 2°C to 8°C for 72 hours and frozen at -70°C for seven days. Frozen samples are stable for one freeze/thaw cycle.

Add On Capable

Not Permitted

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
81596	Under Multianalyte Assays with Algorithmic Analyse

Performing Laboratory Location