Last Modified:
9/23/2019 4:14:54 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:
0.5 mL Serum
Transport & Storage: Temperature/Stability:
14 days Ambient
14 days Refrigerated (preferred)
60 days Frozen
Rejection Criteria:
Gross hemolysis • Gross lipemia • Plasma collected in a PPT potassium EDTA (white-top) tube
Reference Range:
Non-Reactive
Critical Ranges:
Test Comments:
If Hepatitis A Total is positive, test will automatically reflex Hep A IgM
Methodology:
Chemiluminescence
Clinical Significance:
Hepatitis A Virus (HAV) anitbodies indicate prior or acute infection with, or immunization to, Hepatitis A Virus.
Documentation:
Custom Panel:
No
PRODUCTION SCHEDULE
Turn Around Time:
1 to 2 days
Days Performed:
Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed:
Quest - Valencia
PHL Test Code:
HEPTM
EPIC Test Code:
IMO416
Send Out Test Code:
36504
Alternate Test Names:
HAV Reflex IgM; Hep A w/rflx to IgM
Included Tests:
Hepatitis A Antibody IgM; Hepatitis A Antibody Total
CPT Coding:
86708 (Reflex 86709)
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