Last Modified:
8/25/2021 12:48:00 PM
Medicare Medical Necessity Restrictions May Apply
Medical Necessity Documentation:
Client Notes:
Patient Preparation:
Specimen Requirements:
1.0 mL Serum from a Red Top Tube in a Plastic Vial
Collection Instructions:
Minimum Volume:
0.1 mL Serum
Transport & Storage: Temperature/Stability:
Unacceptable Ambient
7 days Refrigerated (transport)
30 days Frozen
Rejection Criteria:
Received Ambient
Reference Range:
Non Reactive
Critical Ranges:
Test Comments:
If the HTLV-I/II Antibody is Reactive, then HTLV-I/II, Western Blot, will be performed at an additional charge.
Methodology:
Immunoassay; Immunoblot
Clinical Significance:
HTLV-I is associated with adult T-cell lymphoblastic leukemia and B-cell chronic lymphocytic leukemia. HTLV-II is less common and is associated with neoplasias of the CD8 T lymphocytes. Blood donor screening began in 1998
Documentation:
Custom Panel:
No
PRODUCTION SCHEDULE
Turn Around Time:
4 to 5 days
Days Performed:
Sunday, Monday, Wednesday, Thursday, Friday
Sites Performed:
Quest - Chantilly
PHL Test Code:
HTLVP
EPIC Test Code:
IMO96
Send Out Test Code:
36175
Alternate Test Names:
HTLV I/II Antibody, w/Reflex to Western Blot; HTLV I/II reflex to WB; HTLV I/II W/REFLEX WB
Included Tests:
HTLV-I/-II Antibody; HTLV I/II, Western Blot
CPT Coding:
86790 (reflexes 86689)
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