Female Testing

Quest makes it easier to test your female patients for infections

Left untreated, STIs and other infections can have devastating consequences for women and their reproductive health. It’s for her protection.

The insights you need to provide the best care for your patients

Chlamydia trachomatis and Neisseria gonorrheae are the 2 most commonly reported notifiable diseases in the United States. They are among the most prevalent of all STDs, and since 1994, have comprised the largest proportion of all STDs reported to Centers for Disease Control and Prevention.¹

In 2018, there were 1,758,668 cases of Chlamydia trachomatis and 583,405 cases of Neisseria gonorrhoeae reported.²

Left untreated, chlamydia and gonorrhea may affect the upper reproductive tract, resulting in pelvic inflammatory disease (PID).³ PID can have devastating consequences for women, including:

Infertility³
Life-threatening ectopic pregnancy,³ the leading obstetrical cause of maternal mortality in the first trimester^4,5
Chronic pelvic pain³

lab tech with test tube in front of laptop

Trichomoniasis (trich) affects more than 3.7 million people across the country, making it the most prevalent nonviral sexually transmitted infection in the US.⁶ More than 11% of women 40 years of age and older are infected with trich. Rates are even higher in women with a history of STIs—with 3 in 10 testing positive for the infection.

Trich can live in your patient’s system for months to years if left untreated.

Most cases of trichomoniasis are asymptomatic. Without symptoms, patients are not always tested, so they remain contagious and can pass the infection to others.⁶ When symptoms do occur, they typically include:

Cervicitis, urethritis, vaginitis

Vaginal discharge that may be malodorous, yellow-green, with or without vulvar irritation

Mycoplasma genitalium is a sexually transmitted pathogen that causes inflammation of the urethra (urethritis) and cervix (cervicitis) and is associated with female pelvic inflammatory disease (PID) and other adverse sexual and reproductive health outcomes. The clinical presentation of Mycoplasma genitalium is similar to many other STIs, such as chlamydia, gonorrhea, and trichomoniasis.⁷

Mycoplasma genitalium is detected in 10%-30% of women with clinical cervicitis⁸
Identified in up to 22% of PID cases⁸
Infected patients are 2 times more likely to acquire HIV⁹

Testing for MGen is part of our comprehensive STI portfolio

Uncover this hidden STI that might be harming your patients

Vaginitis is the most common gynecologic diagnosis in the primary care setting, affecting 1 in 3 women in their lifetime, but diagnosing its cause can be challenging.

The 3 diseases most frequently associated with vaginitis are bacterial vaginosis (BV), caused by an overgrowth of bacteria including Gardnerella vaginalis and anaerobes; vaginal trichomoniasis (TV), caused by Trichomonas vaginalis; and vulvovaginal candidiasis, usually caused by Candida albicans.

Cervicitis is an inflammation of the cervix, the lower, narrow end of the uterus that opens into the vagina. Cervicitis can result from common sexually transmitted infections (STIs), including Mycoplasma genitalium, gonorrhea, chlamydia, trichomoniasis, and genital herpes. Possible symptoms of cervicitis include bleeding between menstrual periods, pain with intercourse or during a cervical exam, and abnormal vaginal discharge. However, it’s also possible to have cervicitis and not experience any signs or symptoms.

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs and often due to sexually transmitted infections including Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and/or Mycoplasma genitalium.

Symptoms may include pain in the lower abdomen and pelvis, heavy vaginal discharge with an unpleasant odor, abnormal vaginal bleeding, and pain during intercourse.

Genital herpes is common in the United States. More than 1 out of every 6 people aged 14 to 49 years have genital herpes.¹³

Genital herpes is caused by 2 types of viruses: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). Oral herpes is usually caused by HSV-1 and can result in cold sores or fever blisters on or around the mouth. Oral herpes caused by HSV-1 can be spread from the mouth to the genitals through oral sex.

A comprehensive test menu for your female patients

Our comprehensive menu provides the tests you need for diagnosing patients who present with symptoms, so you can deliver the highest quality of care—from testing through follow-up.

Laboratory Screening	Test name	Test code	CPT code^a
Chlamydia	Chlamydia trachomatis RNA, TMA, Urogenital	11361	87491
	Chlamydia trachomatis RNA, TMA, Rectal	16505	87491
	Chlamydia trachomatis RNA, TMA, Throat	70048	87491
Gonorrhea	Neisseria gonorrhoeae RNA, TMA, Urogenital	11362	87591
	Neisseria gonorrhoeae RNA, TMA, Rectal	16504	87591
	Neisseria gonorrhoeae RNA, TMA, Throat	70049	87591
Chlamydia and Gonorrhea	Chlamydia/Neisseria gonorrhoeae RNA, TMA, Urogenital	11363	87491, 87591
	Chlamydia/Neisseria gonorrhoeae RNA, TMA, Rectal	16506	87491, 87591
	Chlamydia/Neisseria gonorrhoeae RNA, TMA, Throat	70051	87491, 87591
Trichomonas vaginalis	SureSwab^®, Trichomonas vaginalis RNA, Qualitative, TMA	19550	87661
Trichomonas vaginalis	Trichomonas vaginalis RNA, Qualitative, TMA, Pap Vial	90521	87661
Chlamydia, Gonorrhea and Trichomonas vaginalis	SureSwab^®, CT/NG, T vaginalis	16492	87491, 87591, 87661
Chlamydia, Gonorrhea and Trichomonas vaginalis	Chlamydia/N. gonorrhoeae and T. vaginalis RNA, Qualitative, TMA, Pap Vial	91448	87491, 87591, 87661
Mycoplasma genitalium	Mycoplasma genitalium, rRNA, TMA	91475	87563
Herpes simplex virus 1/2 for lesions	SureSwab^®, Herpes Simplex Virus, Type 1 and 2 mRNA,TMA	90570	87529 (x2)
Herpes simplex virus 1/2 serology	Herpes Simplex Virus 1 and 2 (IgG), with Reflex to HSV-2 Inhibition	17169	86695, 86696
Cervicitis	Sexually-Transmitted Infections (STIs) Cervicitis Panel	36962	87491, 87591, 87661, 87563
Pelvic inflammatory disease (PID)	Sexually-Transmitted Infections (STIs) Pelvic Inflammatory Disease (PID) Panel	36965	87491, 87591, 87661, 87563
Genital Lesion	Sexually-Transmitted Infections (STIs) Genital Lesion Panel	38286	87529 (x2), 87798
Syphilis lesion	Treponema pallidum DNA, Qualitative Real-Time PCR	16595	87798
Syphilis serology	RPR (Diagnosis) with Reflex to Titer and Confirmatory Testing	36126	86592
Hepatitis C	Hepatitis C Antibody with Reflex to HCV, RNA, Quantitative, Real-Time PCR	8472	86803
HPV	HPV mRNA E6/E7, Rectal	91932	87624
	HPV mRNA E6/E7, Rectal with Reflex to Genotypes, 16, 18/45	92810	87624
	HPV Genotypes 16, 18/45, Anal-Rectal	92807	87625
Cytology, non-gynecological	Cytology, Non-Gynecological, Fluid, Washings, Brushings or FNA	10676	88104, 88108, 88112, 88160, 88161, 88162, 87207, 88172, 88173, 88305
Vaginosis/vaginitis	SureSwab^®, Bacterial Vaginosis DNA, Quantitative, Real-Time PCR	10016	81513
	SureSwab^® Advanced Candida Vaginitis (CV), TMA	10121	87481*2
	SureSwab^® Advanced Candida Vaginitis (CV)/Trichomonas vaginalis (TV), TMA	10029	87481*2 87661
	SureSwab^® Advanced Bacterial Vaginosis (BV), CT/NG, TMA	10123	81513, 87491, 87591
	SureSwab^® Advanced Vaginitis, TMA	10119	81513 87481*2 87661
	SureSwab^® Advanced Vaginitis Plus, TMA	10120	81513 87481*2 87661 87491 87591

Components of panels can be ordered separately.

Test codes may vary by location. Please contact your local laboratory for more information.

^a The CPT^® codes provided are based on American Medical Association guidelines an 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.

References:

CDC. Sexually transmitted disease surveillance 2018. Chlamydia. Updated September 30, 2019. Accessed November 19, 2020. https://www.cdc.gov/std/stats18/chlamydia.htm
CDC. Sexually transmitted diseases — reported cases and rates of reported cases, United States, 1941–2018. Updated August 20, 2019. Accessed November 19, 2020. https://www.cdc.gov/std/stats18/tables/1.htm
Farley TA, Cohen DA, Elkins W. Asymptomatic sexually transmitted diseases: the case for screening. Prev Med. 2003;36(4):502-509. doi:10.1016/s0091-7435(02)00058-0
Creanga AA, Shapiro-Mendoza CK, Bish CL, et al. Trends in ectopic pregnancy mortality in the United States: 1980–2007. Obstet Gynecol. 2011;117(4):837-843. doi:10.1097/AOG.0b013e3182113c10
Tenore JL. Ectopic pregnancy. Am Fam Physician. 2000;61(4):1080-1088.
CDC. 2015 Sexually Transmitted Diseases Treatment Guidelines. Trichomoniasis. Updated June 4, 2015. Accessed November 5, 2015. http://www.cdc.gov/std/tg2015/trichomoniasis.htm
Falk L, Fredlund H, Jensen JS. Signs and symptoms of urethritis and cervicitis among women with or without Mycoplasma genitalium or Chlamydia trachomatis infection. Sex Transm Infect. 2005;81(1):73-78. doi:10.1136/sti.2004.010439
CDC. 2015 Sexually Transmitted Diseases Treatment Guidelines. Emerging issues. Updated June 4, 2015. Accessed November 20, 2019. https://www.cdc.gov/std/tg2015/emerging.htm
Napierala Mavedzenge S, Weiss HA. Association of Mycoplasma genitalium and HIV infection: a systematic review and meta-analysis. AIDS. 2009;23(5):611-620. doi:10.1097/QAD.0b013e328323da3e
Egan ME, Lipsky MS. Diagnosis of vaginitis. Am Fam Physician. 2000;62(5):1095-1104.
Workowski KA, Bolan GA, Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64(RR-03):1-137.
CDC. 2015 Sexually Transmitted Diseases Treatment Guidelines. Diseases characterized by vaginal discharge. Updated June 4, 2015. Accessed November 21, 2020. https://www.cdc.gov/std/tg2015/vaginal-discharge.htm
CDC. Genital herpes – CDC fact sheet. Updated August 28, 2017. Accessed November 20, 2020. https://www.cdc.gov/std/herpes/stdfact-herpes.htm

Universal screening with opt-out for CT/NG screening

The latest CDC Guidelines recommended considering universal screening with opt-out as part of routine care for all female patients ages 15 - 24.^*
_{*Workowski KA, et al. MMWR. doi:10.15585/mmwr.rr7004a1}

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