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Home > Medical Laboratories > Specific Laboratory Links > University of Virginia Medical Laboratories Reflex Testing and Procedure Chart

University of Virginia Medical Laboratories Reflex Testing and Procedure Chart

                       

University of Virginia Medical Laboratories Reflex Testing and Procedure Chart

 

 

Initial Requested Test

Reflex Criterion

Reflex Test or Procedure

CPT Code for Reflex Billing

Chemistry

 

*Free Phenytoin(FRPTN)

Phenytoin >   2.5

Free Phenytoin

80186

*Free Carbamazapine(FRCARB)

Carbamazapine

> 2.0

Free Carbamazapine

80156

*Free Valproic Acid(FRVALP)

Valproic Acid

> 12.0

Free Valproic Acid

80164

*Free Digoxin (FDIG)

Digoxin > 2.0

Free Digoxin

80162

TSH Reflexive (TSHR)

TSH < 0.45 or >   4.50

Free T4

84439

Qualitative HCG with   reflex to Quantitative HCG (HCGQR)

Postive qualitative   result

Quantitative HCG

84702

Alkaline Phosphatase   Fractionated

Alkp > 150

Fractionate Alkaline   Phosphatase (heated)

84078

*HIV-1 / HIV-2   Antibody Screen (HIV12, HIVNS, HIVNE)

Positive

BioRad Geenius HIV   1/2

 

86703

 

*Hepatitis B Surface   Antigen (HBSAG)

Positive

Hepatitis B   Confirmation (if not previously done)

 

87301

  

*Serum Protein   Electrophoresis (SPEP)

Abnormal findings

IG Quantitation

(QUANT)   Immunofixation (IMFIX)/Freelites

82784 x3

83883 x2

 

*Serum Protein   Electrophoresis / Urine Protein Electrophoresis(SPEP / URPEP)

Abnormal findings not   resolved by QUANTP/Freelites

Immunofixation

(IMFIX)/Band present

86334

*Hemoglobin   Electrophoresis (HGBEP)

Abnormal Hemoglobins

Hemoglobin Acid   Electrophoresis

(ACIDHB)

83020

 

 

*Hemoglobin   Electrophoresis (HGBEP)

Abnormal findings of   A2 or F

Quantitation for A2 or F  (send out)

83021

Note: Free Drug test   request includes free and total drug levels

 

Microbiology/Molecular 

*Throat Screen for   Strep (TS)

Negative

Culture

87081

 

 

 

*Bacterial Culture

 

Positive

Identification

Susceptibility

87077

87070

83789

87185

87156

87181

87184

 

*Fungal Culture

Positive

        Identification        

Susceptibility

87106

83789

87186

 

*Cryptococcal AG (CRYPG)

Cryptococcal Ag   Positive

Funcal Culture, CSF   (FUNCSF)

87102

*AFB Culture

Positive

Identification

87118

83789

87149

 

*Viral Culture

Positive

Identification

87253

87254

87252

*Fragile X (FXDNA)

One peak or no result

Southern Blot (FXSOU)

81244

 

Genomics

*Colorectal CA Molecular Analysis

 KRAS  

no mutation detected

BRAF

and

NRAS

81210

 

81404

 

Toxicology 

*Drugs of Abuse   Screening

Any positive results

Confirmation

80102

 

Immunology 

*Serum Syphillis   Screen (SYPIGG)

Equivocal (0.–1.0) 

or 

Reactive (>1.0)

Rapid Plasma Reagin   Titer (RPRT) Quantitation

86593

*SYPIGG and RPRT

Discordant results   and no previous history

Treponemal Pallidum   Antibody Assay

(TPPA)

86780

 

 

Celiac IgA Panel

<7 mg/dL

Celiac IgG Panel

83516 (X2)

 

Cytology 

Thin Prep Pap

ACS or AGS Diagnosis

Human Papillomavirus(HPVGEN)

87621

 

Blood Bank 

*Type and Hold

Positive Antibody   Screen

Antibody   Identification(ABID)

 

86870

 

 

*Type and Hold

Positive Antibody   Screen

Antigen Information (AGIO)

86903

(per antigen per unit   crossmatched)

*Type and Hold (on   patient scheduled for surgery)

Positive Antibody   Screen

Crossmatch two units   of blood

86920

*Type and Screen

Positive Antibody   Screen

Antibody   Identification(ABID)

 

 

86870

 

 

*Antibody Screen(ordered   separately  or as part of battery)

Positive Antibody   Screen

Antibody   Identification(ABID)

 

 

86870

 

 

*Antibody   Identification

Inconclusive Result

Direct Antiglobulin   Test

 

86880

 

*NewAntibody   Identification

All Patients

Direct Antiglobulin   Test, Elution,

Drug-Associated   Antibody Identification,

Phenotype and/or RBC   antigen genotype

 

86880

86890 & 86870 86978

 86903

Direct Antiglobulin   Test (polyspecific)

Positive

Direct Antiglobulin   Test(monospecific)

 

 

86880

 

 

Direct Antiglobulin   Test

Positive

No current antibody   screen on file.

Antibody Screen

86850

Platelet Evaluation

Positive

Platelet Crossmatch

86023

Cord Blood Workup

If the mother has a   non-ABO IgG antibody or is Group O and the child is Group A or B, or no   current mother’s sample is available

Direct Antiglobulin   Test

86880

Cord Blood Workup

Positive Direct   Antiglobulin Test

Antibody   Screen if no current mother’s sample

86850

Cord Blood Workup

Positive Direct   Antiglobulin Test and mother has an IgG antibody

Eluate

86860

86870

 

*Fetal Bleed Screen

Positive

Fetal Hemoglobin   Stain

85460

*Fetal Bleed Screen

Infant with weak D

Fetal Hemoglobin   Stain

85460

*Transfused Red Cells

Patient with Antibody

Antigen type units

86903

(per antigen per unit   crossmatched)

Type and Hold

Diagnosis of sickle   cell disease

Phenotype patient’s   red cells

86905

86906

Transfused Red Cells

Diagnosis of sickle   cell disease

Antigen typing Rh and   K compatible units

86903

 

Transfused Red Cells

Diagnosis of   Thalassemia or patient with warm autoantibody that has not been recently   transfused

Phenotype patient’s   red cells

86905

86906

Transfused Red Cells

Chronically   transfused patient

Phenotype patients   red cells

86905

86906

Transfuse Red Cells

Previously transfused   patient with auto-antibody

Auto- or differential   absorptions

86978

*Transfusion Reaction   Workup

Positive Direct   Coombs in which new antibody is discovered

Elution and antigen   typing of all transfused units

86860

86870

86903

*HLA or cross-matched   platelets

None

Irradiate

86945

 

*Transfuse cellular   products

All red cell and   platelet products

Irradiate

86945

 

Reference Lab 

*Borrelia burgdorferi   antibody

(Lyme’s Disease)

Positive or equivocal

Western Blot

 

 

86617 (x2)

 

 

Paraneoplastic Autoantibody Screen

Dependent upon   initial results

Varies

Variable depending   upon Ab found

*Mycoplasma pnuemoniae Antibodies, IgG and IgM, Serum

If IgM is positive or   equivocal

IgM by indirect   immunofluorescence  assay (IFA)

86738

 

 

Cytogenetics 

Amniotic Fluid Study

(CTGAFS)

Suspicious or   abnormal standard chromosome finding

Fluorescent in situ   hybridization

88271

and one of the following:

88272

88273

88274

88275

 

Chorionic Villus   Sample (CTGCVS)

Suspicious or   abnormal standard chromosome finding

Fluorescent in situ   hybridization

88271

and one of the   following:

88272

88273

88274

88275

 

Lymphocyte Study(CTGLS)

Suspicious or abnormal   standard chromosome finding

Fluorescent in situ   hybridization

88271

and one of the   following:

88272

88273

88274

88275

 

*Bone Marrow / Unstim. Blood(CTGBMS)

Suspicious or   abnormal standard chromosome finding

Fluorescent in situ   hybridization

88271

and one of the   following:

88272

88273

88274

88275

 

Fibroblast Study(CTGFBS)

Suspicious or   abnormal standard chromosome finding

Fluorescent in situ   hybridization

88271

and one of the   following:

88272

88273

88274

88275

Tumor Study (CTGSTS)

Suspicious or abnormal   standard chromosome finding

Fluorescent in situ   hybridization

88271

and one of the   following:

88272

88273

88274

88275

Chromosome Microarray  (CMA)

Abnormal screen

Fluorescent in situ   hybridization

88271

and one of the   following:

88272

88273

88274

88275

 

Urinalysis 

Urinalysis with   reflex culture (UACUL)

positive leukocyte   esterase, or

positive nitrite, or

>5 white blood   cells/HPF, or

any bacteria present

Urine Culture

87086

 

Hematology 

Lamelar Body Count

Values between 35 and   50 k/microL

Phosphatidyl Glycerol   AmnioStat (PGA)

84081

 

Student Health (only)

CBC

Any lymph generated flag, or absolute lymphocyte count > absolute   granulocyte count, or   absolute lymphocyte count >2.1, or   platelet count < 150

Monospot

86308

 

 

Surgical Pathology

 

 

Biopsy or Consult Request

Diagnosis of:

1. Glioglastoma (Astrocytoma WHO grade IV)

or

2. Anaplastic Astrocytoma (Astrocytoma WHO grade III)

or

3. Anaplastic Oligoastrocytoma (WHO grade III)

or

4. Anaplastic Olidendroglioma (WHO grade III)

or

5.   Anaplastic Ependymoma (WHO grade III)

MGMT (O6-Methylguanine-DNA Methytransferase) Gene   Methylation Assay

83891

83896 (x2)

83898 (x2)

83907

83912

 

* Denotes Mandatory Reflex Testing