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SurePath® Pap reflex HPV DNA

Test Code

14499

CPT Code(s)

88142; HCPCS: G0123

Includes

Pap results requiring physician interpretation will be performed at an additional charge (CPT code(s): 88141; HCPCS: G0124)
For Interpretations of Atypical Squamous Cells (ASC), HPV DNA, High Risk will be performed at an additional charge (CPT code(s): 87621).

Preferred Specimen(s)

Pap sample collected with a cytobroom. Cytobroom tip submitted in a SurePath® vial. Alcohol based solution that serves as preservative and transport media for gynecological samples.

See Gynecologic Specimens: The "Pap" Test in the Cytology section of Specimen Collection and Handling.

Minimum Volume

Gynecological sample collected with cytobroom in routine manner and broom tip deposited in SurePath® vial

Collection Instructions

Provide all patient information using the Cytology test requisition.

Brush/Spatula Device (PapPerfect Spatula and CytoBrush GT)
1. Complete the test requisition.

2. Record the patient's First Initial and Full Last Name or unique identifier on the vial.

3. Select contoured end of Pap Perfect plastic spatula and rotate 360° around the entire exocervix while maintaining tight contact with exocervical surface.

4. Visually locate the notched score line on the side of the spatula handle, about 4 cm from the contoured collection end. With gloved hand(s) and one single, quick, and firm SNAP, separate the contoured end from the rest of the spatula handle. Do not touch collection end. Drop this contoured end into a vial of SurePath® preservative (supplied by TriPath Imaging, Inc.). Discard remaining device handle end of the spatula after each use. Place cap on vial until step 6; do not tighten cap.

5. Insert Cytobrush Plus GT device into the endocervix until only the bottom-most bristles are exposed at the os. Slowly rotate 1/4-1/2 turn in one direction. To reduce unnecessary bleeding, do not over-rotate brush. Over-rotation may result in poor sample collection. Remove cytobrush device.

6. Visually locate the notched score line on the side of the cytobrush handle, about 4 cm from the brush tip. With gloved hand(s) and one single, quick, and firm SNAP, separate the brush head-short handle from the rest of brush handle. Do not touch collection end. Drop brush head-short handle into the same vial of SurePath® preservative. Discard remaining device handle end of cytobrush.

7. Tighten the SurePath® vial cap so the torque line on the cap passes the torque line on the vial. Attach to SurePath® vial an appropriate requisition form and send to lab in a specimen bag for transport to the laboratory.

Broom-Like Device (Rover's Cervex-Brush®)
1. Complete the Cytology test requisition.

2. Record the patient's first initial and full last name or unique identifier on the vial.

3. Obtain an adequate sampling from the cervix using a broom-like device.

4. Insert the central bristles of the broom into the endocervical canal deep enough to allow the shorter bristles to fully contact the ectovcervix. Push gently, and rotate the broom in a clockwise direction five times. DO NOT ROTATE IN A COUNTERCLOCKWISE DIRECTION.

5. Remove and "pop-off" broom head into the SurePath® vial.

6. Tighten the cap so the torque line on the cap passes the torque line on the vial.

7. Place the vial and requisition in a specimen bag for transport to the laboratory.

Transport Container

SurePath® vial

Transport Temperature

Room temperature

Specimen Stability

Room temperature: 28 days
Refrigerated: 6 months

Reject Criteria

Unlabeled vial • Leakage of fluid during transport • Mismatch between name of patient on vial and name on test requisition • SurePath® (blue) vials without the head of the collection device(s) in the fluid

Methodology

Liquid Based-Density Gradient Sedimentation

The performance characteristics of this assay have been determined by Quest Diagnostics. Performance characteristics refer to the analytical performance of the test when used to test SurePath® or Vaginal specimens.

Performing Laboratory

Quest Diagnostics-Cincinnati
6700 Steger Drive
Cincinnati, OH 45237-3046

Reference Range(s)

See Laboratory Report

Clinical Significance

Liquid based pap testing is intended for use in the screening and detection of cervical cancer, pre-cancerous lesions, atypical cells and all other cytologic categories as defined by the bethesda system for reporting results of cervical cytology. Pap screening is not reliable for the detection of endometrial cancer.

Alternative Name(s)

Pap SurePath® Reflex HPV, Cytology SurePath® with Reflex HPV

LOINC®' Code(s)

The Result and LOINC information listed below should not be used for electronic interface maintenance with Quest Diagnostics. Please contact the Quest Diagnostics Connectivity Help Desk for more information at 800-697-9302.

NOTE: The codes listed in the table below are not orderable Test Codes.

Result
Code
Result NameLOINC CodeComponent Name
90000225SOURCE:19763-2Specimen source
90000555REPORT STATUS:8251-1Service comment
90000571CLINICAL INFORMATION:55752-0Clinical information
90000597LMP:8665-2Date last menstrual period
90000613PREV. PAP:60432-2Date of previous PAP smear
90000639PREV. BX:60431-4Date of previous biopsy
90000712STATEMENT OF ADEQUACY:19764-0Statement of adequacy
90000779GENERAL CATEGORIZATION:19762-4General categories
90001256INTERPRETATION/RESULT:10524-7Microscopic observation
90001280COMMENT:19774-9Cytology study comment
90020926CYTOTECHNOLOGIST:19767-3Cytologist
90020959REVIEW CYTOTECHNOLOGIST:19767-3Cytologist
90020983PATHOLOGIST:19769-9Pathologist
90021122INFECTION:49034-2Microorganism identified

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 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 payer being billed.

LOINC assignment is based on a combination of test attributes, including the method used by the performing laboratory. For tests not performed by Quest Diagnostics, codes are assigned by the performing laboratory.

* The tests listed by specialist are a select group of tests offered. For a complete list of Quest Diagnostics tests, please refer to our Directory of Services.