Test Code:
RPR (Diagnosis) w/ Reflex to Titer and T.pallidum Ab, IA (Traditional): 36126
RPR (Montior) w/ Reflex to Titer: 799
CPT Code(s):
RPR (Diagnosis) w/ Reflex to Titer and Confirmatory Testing: 86592
RPR (Montior) w/ Reflex to Titer: 86592
Methodology: Flooculation
Clinical Significance:
RPR (Diagnosis) w/ Reflex to Titer and Confirmatory Testing: This test is used to aid in the diagnosis of syphilis using the traditional algorithm. The algorithm starts with RPR, a nontreponemal (lipoidal antigen) serologic test, and if reactive will reflex to titer. Reactive RPR samples will be further tested with the Treponema pallidum Antibody immunoassay, a treponemal serologic test.
Testing can be performed for individuals suspected of syphilis based on signs and symptoms or for screening asymptomatic individuals. Screening is recommended in certain populations at increased risk for infection and pregnant women.
False positive results with nontreponemal (lipoidal antigen) test results may occur due to wide range of biological conditions (e.g., autoimmune disease, cancer, infectious diseases, old age, and pregnancy). False negative can occur in persons with recent exposure. Persons with previously treated syphilis will remain positive using a treponemal test. Therefore, a single type of serological test is insufficient for diagnosis and positive result using a nontreponemal (lipoidal antigen) test should be confirmed by a treponemal specific assay using the traditional algorithm.
RPR (Monitor) w/ Reflex to Titer: This is a nontreponemal (lipoidal antigen) serologic test used to monitor patients diagnosed with syphilis. RPR reactive samples will be reflexed to titer. Titer results may correlate with disease activity and typically decrease in response to treatment.
Serologic evaluation is recommended at 6 and 12 months for primary and secondary syphilis. Follow-up testing should be performed using the same nontreponemal (lipoidal antigen) test and be performed by the same laboratory so that results are comparable over time.
False positive results with nontreponemal (lipoidal antigen) test may occur due to wide range of biological conditions (e.g., autoimmune disease, cancer, infectious disease, old age, and pregnancy).
Includes:
RPR (Diagnosis) w/ Reflex to Titer and Confirmatory Testing: If RPR screen is reactive, RPR Titer and Fluorescent Treponemal Antibody (FTA) Confirmatory testing will be performed at an additional charge (CPT code(s): 86593, 86780).
RPR (Monitor) w/ Reflex to Titer: If RPR Screen is reactive, RPR titer will be performed at an additional charge (CPT code(s): 86593).
Alternative Name(s):
RPR (Diagnosis) w/ Reflex to Titer and Confirmatory Testing: Premarital RPR,Syphilis Serology Screen, Blood,ART,Rapid Plasma Reagin,Automated Reagin Test
RPR (Monitor) w/ Reflex to Titer: Syphilis
Supply: #T157 Red/Yellow SST 8mL
Preferred Specimen: Serum
Preferred Volume: 1mL
Transport Container: Serum Separator Tube (SST)
Transport Temperature: Room Temperature
Specimen Stability: Room Temperature: 4 Days
Rejection Criteria:
- Contact DLO's Customer Service for specific criteria.
- Hemolysis
- What are hemolyzed specimens?
- Hemolysis occurs when the red cells are damaged during sample collection causing them to rupture. Hemolyzed serum or plasma is pale pink to red rather than the normal clear straw or pale-yellow color.
- What causes a specimen to be hemolyzed?
- Mixing tubes too vigorously
- Placing tubes in the refrigerator without allowing 30 minutes at room temperature for complete clotting
- Exposure to heat or in a refrigerator that is too cold
- Using a needle with too small of a bore necessary for the venipuncture
- Using too large a tube when using a butterfly needle
- Not allowing sufficient time for alcohol to dry on puncture site
- Leaving the tourniquet on for longer than one minute
- How can hemolyzed specimens be prevented?
- For routine collections, use a 20–22-gauge needle
- Do not remove the needle from the vein with the vacuum tube engaged
- Do not collect a specimen in a hematoma
- Do not centrifuge the specimen for a prolonged period of time
- Draw the sample gently and evenly
- What are hemolyzed specimens?
- Specimens exceeding stability
- Specimens other than serum
- Unlabeled or improperly labeled specimens
For additional supply or collection information, please contact DLO's Customer Service at (800) 891-2917, option 2.
The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the Payor being billed.