Viral Culture, Rapid, Lesion (Herpes Simplex Virus and Varicella Zoster Virus)
CPT:
87254; 87255
Synonyms
- Herpes Simplex and Varicella Zoster
- HSV and VZ Culture
- Lesion Culture
- Viral Culture, Rapid, Varicella Zoster
- Virus Isolation
Test Includes
Cell culture by ELVIS® method; identification and typing of herpes simplex virus. Shell vials or equivalent multiwell plate culture with fluorescent antibody staining for varicella-zoster. CPT coding for microbiology and virology procedures often cannot be determined before the culture is performed. This culture is for the isolation of herpes simplex and varicella-zoster, other viral agents will not be routinely detected. If a virus other than the one specified for this virus-specific culture is recovered, identification will be made, and an additional charge will apply. The client will not be telephoned to approve this charge. Requests with only a written order and no test number indicated will be processed according to Default Testing for Virology.
Special Instructions
If reflex test is performed, additional charges/CPT code(s) may apply.
Submit one specimen per test requested. Specify the exact specimen source/origin (eg, genital lesion). Indicate a specific test number on the test request form. Do not use transport device beyond the expiration date.
Expected Turnaround Time
5 - 6 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 Information
Related Documents
Specimen Requirements
Specimen
Vesicular fluid, ulcerated lesions, vesicular scrapings, pharyngeal and throat swabs, autopsy and biopsy material, vaginal swabs
Volume
Swab in viral transport media, 0.5 g tissue in viral transport medium
Container
Viral, Chlamydia, or Mycoplasma culture transport provided by LabCorp, or other appropriate transport medium; sterile screw-cap container
Collection
Specimen is best collected within the first three days after appearance of lesion, but no longer than seven days. Do not prepare the collection site with alcohol or iodophors. After collection, remove cap from the transport media tube and insert swab aseptically into transport tube and break swab shaft. Replace cap so that swab will not interfere with closure and allow tube to leak. Label tube with patient identification and transport to the laboratory at 4°C.
Storage Instructions
Specimen should be kept at 4°C (refrigeration) and transported to the laboratory within 24 hours of collection.
Causes for Rejection
Bacterial swab specimen; specimen received in grossly leaking transport container; dry specimen; specimen submitted in fixative or additive; specimen received in expired transport media or incorrect transport device; inappropriate specimen transport conditions; specimen received after prolonged delay in transport (usually more than 72 hours); specimen stored or transported at room temperature; wooden shaft swab in transport device; unlabeled specimen or name discrepancy between specimen and request label
Test Details
Methodology
Enzyme-linked virus-inducible system (ELVIS®). ELVIS® HSV was developed using a transgenic baby hamster kidney-21 cell line. In this cell line, HSV infection causes the expression of a beta-galactosidase “reporter gene,” and it is the expression of this gene that can be used to monitor infection by HSV. Cultures positive by ELVIS® are confirmed by immunofluorescent staining. Shell vials or equivalent multiwell plate culture with fluorescent antibody staining is utilized for the recovery of varicella-zoster.
References
Arvin AM, Prober CG. Herpes simplex viruses. In: Balows A, Hausler WJ, et al, eds. Manual of Clinical Microbiology. 5th ed. Washington, DC: ASM Press; 1991:822-828.
Drew WL. Diagnostic virology. Clin Lab Med. 1987; 7(4):721-740 (review). 3319366
Reichman RC. Herpes simplex viruses. In: Belshe RB, ed. Textbook of Human Virology. Littleton, Mass: PSG Publishing Co;1984:811-828.
Schauf V, Tolpin M. Varicella-zoster virus. In: Belshe RB, ed.Textbook of Human Virology. Littleton, Mass: PGS Publishing Co;1984:829-851.
Solomon AR. New diagnostic tests for herpes simplex and varicella zoster infections. J Am Acad Dermatol. 1988; 18(1 Pt 2):218-221. 2448353
Strommen GL, Pucino F, Tight RR, et al. Human infection with herpes zoster: Etiology, pathophysiology, diagnosis, clinical course, and treatment. Pharmacotherapy. 1988; 8(1):52-68 (review).3287356
LOINC® Map
| Order Code | Order Code Name | Order Loinc | Result Code | Result Code Name | UofM | Result LOINC |
|---|---|---|---|---|---|---|
| 186056 | Viral Culture,Rapid,Lesion | 6584-7 | 186057 | HSV Culture/Type | 5858-6 | |
| 186056 | Viral Culture,Rapid,Lesion | 6584-7 | 186058 | Viral Culture, Rapid,Varicella | 10860-5 |
| Reflex Table for HSV Culture/Type | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 186059 | Viral Identification | 186059 | Viral Identification | 615-5 | |
| Reflex Table for Viral Culture, Rapid,Varicella | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 186060 | Viral Identification | 186060 | Viral Identification | 615-5 | |
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