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SurePath Imaging Pap - Broom

Test Code Test Name CPT Code
18810 Pap 88175 (HCPCS: G0145)
18811 Pap reflex HPV mRNA E6/E7 (age <21) 88175 (HCPCS: G0145)
18813 Pap and HPV mRNA E6/E7 ages 30-65) 88175 (HCPCS: G0145), 87624
18828 Pap and HPV mRNA E6/E7,C. trachomatis, N. gonorrhoeae 88175 (HCPCS: G0145), 87624, 87491, 87591
18829
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SurePath Imaging Pap - Spatula & Brush

Test Code Test Name CPT Code
18810 Pap 88175 (HCPCS: G0145)
18811 Pap reflex HPV mRNA E6/E7 (age <21) 88175 (HCPCS: G0145)
18813 Pap and HPV mRNA E6/E7 ages 30-65) 88175 (HCPCS: G0145), 87624
18828 Pap and HPV mRNA E6/E7,C. trachomatis, N. gonorrhoeae 88175 (HCPCS: G0145), 87624, 87491, 87591
18829
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BRCAvantage™ Comprehensive

BRCAvantage™ Comprehensive

Test Code: 91863

CPT Code(s): 81162

Supply: 193292 Lavender 4mL Blood Tube

Includes:
BRCA1 Sequencing, BRCA1 Deletion/Duplication, BRCA2 Sequencing, BRCA2 Deletion/Duplication, Comprehensive Interpretation

Methodology:
Next Generation Sequencing • Multiplex Ligation-dependent Probe Amplification (MLPA)

Reference Range(s): See Laboratory Report

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AFFIRM™ BV/Vaginitis Panel DNA Probe

Bacterial Vaginosis/Vaginitis Panel

Test Code: 14577

CPT Code(s): 87480, 87510, 87660

Includes: Candida species, Trichomonas vaginalis, Gardnerella vaginalis

Methodology: DNA Probe

Special Instructions: Cervical specimens should be avoided because of the effect of elevated sialidase activity. Specimens should not be collected from a patient who has used any vaginal product in the previous 72 hours, e.g., cream, gel, spermicide, or douching.

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Urinalysis, Reflex to Microscopic

Test Code: 7909

CPT Code(s): 81003

Includes: a microscopic examination is performed, when appropriate, at an additional charge (cpt code(s): 81015).

**This order code does not include Reflex to Culture**

If reflex to culture is desired: Please order Test Code 3020, “Urinalysis, Complete, with Reflex to Culture”

Methodology: Reagent impregnated strips/tablets/microscopic examination if urine macroscopic or dipstick indicates

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Urinalysis, Complete, with Reflex to Culture

Test Code: 3020

CPT Code(s): 81001

Clinical Significance: Dipstick urinalysis is important in accessing the chemical constituents in the urine and the relationship to various disease states. Microscopic examination helps to detect the presence of abnormal urine cells and formed elements. Culture may identify the organism(s) causing infection.

Includes: Macroscopic and Microscopic Examinations - A culture is performed, when appropriate, at an additional charge (CPT code(s): 87088, 87086).

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PTH, Intact and Ionized Calcium

Test Code: 36736

CPT Code(s): 82310, 82330, 83970

Includes: PTH Intact, Calcium, Ionized Calcium

Methodology: PTH Immunoassay (IA) • Calcium: Spectrophotometry (SP) • Ionized Calcium: Ion Specific Electrode (ISE)

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Chlamydia / N. Gonorrhoeae RNA, TMA - Vaginal Collection

Test Code: 11363

Includes: Chlamydia trachomatis, Neisseria gonorrhoeae

Methodology: Dual Kinetic Assay (DKA) • Target Capture • Transcription-Mediated Amplification (TMA)

Reference Range(s):
C.trachomatis RNA, TMA - Not detected
N.gonorrhoeae RNA, TMA - Not detected

This test was performed using the APTIMA® COMBO2 Assay (GEN-PROBE).

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Chlamydia / N. Gonorrhoeae RNA, TMA - Unisex Collection

Test Code: 11363

Includes: Chlamydia trachomatis, Neisseria gonorrhoeae

Methodology: Dual Kinetic Assay (DKA) • Target Capture • Transcription-Mediated Amplification (TMA)

Reference Range(s):
C.trachomatis RNA, TMA - Not detected

N.gonorrhoeae RNA, TMA - Not detected

This test was performed using the APTIMA® COMBO2 Assay (GEN-PROBE).

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Urine Culture

Urine Culture, Routine

Test Code: 395
CPT Code(s): 87086
Includes: If culture is positive, CPT code(s): 87088 (each isolate) will be added with an additional charge. Identification will be performed at an additional charge (CPT code(s): 87077 or 87140 or 87143 or 87147 or 87149). Antibiotic susceptibilities are only performed when appropriate (CPT code(s): 87181 or 87184 or 87185 or 87186).

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