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SUREPATH(R) IMAGING PAP W/RFL HPV MRNA E6/E7

Test Code

18811X

Includes

If SurePath® Imaging Pap result is ASCUS, HPV mRNA E6/E7 will be performed at an additional charge (CPT code(s): 87621).

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)

Specimen Type Refer to Special Handling Instructions
Specimen State Room temperature
PREFERRED SPECIMEN:
PAP sample collected with a broom-like device, the
collection device tip is submitted in a SurePath(R) vial.
Ethanol (alcohol) based solution serves as preservative and
transport media for gynecological samples.

Specimens must be transferred into an APTIMA(R) Specimen
Transfer Tube (green label) for mRNA HPV testing within 7
days of collection if stored at room temperature.

MINIMUM VOLUME:
Gynecological sample collected with cytobroom in routine
manner and broom tip deposited in SurePath(TM) vial.

STABILITY:
Room temperature:
Pap - 28 days from date of collection
HPV - 7 days from date of collection
Refrigerated:
Pap - 6 months
HPV - 7 days from date of collection
Frozen: Unacceptable for pap testing

Special note regarding HPV RNA testing:
1. HPV can only be performed on the SurePath residual fluid
after the pap has been processed if the specimen is not
older than 7 days from the date of collection.
2. Add-on HPV tests: HPV can only be performed on the
SurePath residual fluid specimen if the specimen is not
older than 7 days from the date of collection.
3. RNA HPV cannot be performed on vaginal sources. Refer to
DNA HPV test code 10801A and DNA Genotype test code
19865.

Reject criteria:
Unlabeled vial; leakage of fluid during transport; mismatch
between name of patient on vial and name on test
requisition; SurePath(R) (blue) vials without the tip of
the collection device(s) in the fluid; specimens submitted
frozen.

Transport Container

Refer to handling instructions

Methodology

Liquid Based-density Gradient Sedimentation

Performing Laboratory

60-CYTOLOGY

Setup Days

M,T,W,TH,F

Report Available

3 DAYS

Reference Range(s)

18811X SUREPATH(R) IMAGING PAP W/RFL HPV MRNA E6/E7
CONSTITUENTS [LOINC] UNITS SEX/HI AGE NORMALS
==================== ===== ========== =======
Z3455 [105247] RESULTS
Z3456 [] FINAL STATUS (NEVER REPORT)
Z3457 [] CPT CODE (NEVER REPORT)
Z4776 [82511] REPORT STATUS:
Z4777 [557520] CLINICAL INFORMATION:
Z4779 [86652] LMP:
Z4800 [604322] PREV. PAP:
Z4849 [604314] PREV. BX:
Z4850 [421867] NUMBER OF SLIDES:
Z4853 [197632] SOURCE:
Z4860 [197640] STATEMENT OF ADEQUACY:
Z4861 [197624] GENERAL CATEGORIZATION:
Z4868 [105247] INTERPRETATION/RESULT:
Z4869 [490342] INFECTION:
Z4908 [197749] COMMENT:
Z5360 [197673] CYTOTECHNOLOGIST:
Z5375 [197673] REVIEW CYTOTECHNOLOGIST:
Z5867 [197699] PATHOLOGIST:

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.

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
Z3455RESULTS10524-7Microscopic observation
Z4776REPORT STATUS:8251-1Service comment
Z4777CLINICAL INFORMATION:55752-0Clinical information
Z4779LMP:8665-2Date last menstrual period
Z4800PREV. PAP:60432-2Date of previous PAP smear
Z4849PREV. BX:60431-4Date of previous biopsy
Z4850NUMBER OF SLIDES:42186-7Number of specimens received
Z4853SOURCE:19763-2Specimen source
Z4860STATEMENT OF ADEQUACY:19764-0Statement of adequacy
Z4861GENERAL CATEGORIZATION:19762-4General categories
Z4868INTERPRETATION/RESULT:10524-7Microscopic observation
Z4869INFECTION:49034-2Microorganism identified
Z4908COMMENT:19774-9Cytology study comment
Z5360CYTOTECHNOLOGIST:19767-3Cytologist
Z5867PATHOLOGIST:19769-9Pathologist

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.