Viral Hepatitis Screening and Diagnosis (HAV and HBV)
CPT:
86704; 86706; 86708; 87340. If reflex testing is performed, concomitant CPT code(s)/charge(s) will apply.
Synonyms
- Hepatitis
- Hepatitis A
- Hepatitis B
Test Includes
Hepatitis B surface Antigen (HBsAg) Screen, Qualitative [006510]; Hepatitis B Surface Antibody, Qualitative [006395]; Hepatitis B Core Antibody, Total with reflex to IgM [160101]; Hepatitis A Virus (HAV) Antibody, Total with reflex to IgM [144226]
Special Instructions
If reflex test is performed, additional charges/CPT codes may apply.
This test may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H, or coenzyme R). It is recommended to ask all patients who may be indicated for this test about biotin supplementation. Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample.
Expected Turnaround Time
1 - 3 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Related Documents
Specimen Requirements
Specimen
Serum or EDTA plasma
Volume
7 mL
Minimum Volume
3 mL
Container
Gel-barrier tube, red-top tube or lavender-top (EDTA) tube, serum transfer tube, plasma transfer tube
Collection
If tube other than a gel-barrier tube is used, transfer separated serum/plasma to a labelled plastic transport tube. Do not freeze gel-barrier tube (pour off serum first).
Storage Instructions
Room temperature
Stability Requirements
Temperature | Period |
|---|---|
Room temperature | 14 days |
Refrigerated | 14 days |
Frozen | 14 days |
Freeze/thaw cycles | Stable x3 |
Causes for Rejection
Heat-inactivated specimens; cord blood; cadaveric specimens; or body fluid other than serum or EDTA plasma; gross hemolysis; excessive lipemia; improper labeling
Test Details
Use
Aid in the diagnosis of viral hepatitis due to infection with HAV and/or HBV.
Limitations
The assays in this panel have not been FDA cleared or approved for the screening of blood or plasma donors. Assay performance characteristics have not been established for immunocompromised or immunosuppressed patients, cord blood, or patients less than 2 years of age.
Methodology
Immunochemiluminometric assay (ICMA)
Additional Information
Interpretation | HAV Ab, Total | HAV Ab, IgM |
|---|---|---|
Susceptible/no indication of infection | - | TNI |
Previously vaccinated against or infected with HAV | + | - |
Acute infection | + | + |
Interpretation | HBsAg | anti-HBs | anti-HBc | IgM anti-HBc |
|---|---|---|---|---|
* Multiple possibilities: resolved infection (most common); false-positive anti-HBc (susceptible); "low-level" chronic infection; resolving acute infection. | ||||
Susceptible/no evidence of infection | - | - | - | TNI |
Immune due to natural resolved infection | - | + | + | TNI |
Immune due to vaccination | - | + | - | TNI |
Acute infection | + | - | + | + |
Chronic infection | + | - | + | - |
Intrepretation unclear* | - | - | + | ± |
References
Abara WE, Oaseem A, Schillie S. McMahon BJ, Harris AM, High Value Care Task Force of the American College of Physicians and the Centers for Disease Control and Prevention. Hepatitis B Vaccination, Screening, and Linkage to Care: Best Practice Advice from the American College of Physicians and the Centers for Disease Control and Prevention. Ann Intern Med. 2017 Dec 5;167(11):794-804.29159414
Centers for Disease Control and Prevention. Hepatitis B. CDC web site: www.cdc.gov/hepatitis/hbv/index.htm. Accessed May 2021.
Nelson NP, Weng MK, Hofmeister MG, et al. Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020. MMWR Recomm Rep. 2020 Jul 3;69(5):1-38.32614811
Terrault NA, Lok ASF, McMahon BJ, et al. Update on Prevention, Diagnosis, and Treatment of Chronic Hepatitis B: AASLD 2018 Hepatitis B Guidance. Hepatology. 2018 Apr;67(4):1560-1599.29405329
Workowski KA, Bolan GA; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015 Jun 5;64(RR-03):1-137.26042815
LOINC® Map
| Order Code | Order Code Name | Order Loinc | Result Code | Result Code Name | UofM | Result LOINC |
|---|---|---|---|---|---|---|
| 144552 | HAV, HBV Panel | Pending | 006510 | HBsAg Screen | 5196-1 | |
| 144552 | HAV, HBV Panel | Pending | 006408 | Hep B Surface Ab, Qual | 22322-2 | |
| 144552 | HAV, HBV Panel | Pending | 006718 | Hep B Core Ab, Tot | 13952-7 | |
| 144552 | HAV, HBV Panel | Pending | 006726 | Hep A Ab, Total | 13951-9 |
| Reflex Table for HBsAg Screen | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 016105 | HBsAg Confirmation | 016105 | HBsAg Confirmation | 7905-3 | |
| Reflex Table for Hep B Core Ab, Tot | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 126881 | HBcIgM | 016881 | Hep B Core Ab, IgM | 24113-3 | |
| Reflex Table for Hep A Ab, Total | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 006734 | Hep A Ab, IgM | 006734 | Hep A Ab, IgM | 13950-1 | |
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