Viral Hepatitis Screening and Diagnosis (HAV and HBV)

TEST: 144552
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CPT: 86704; 86706; 86708; 87340. If reflex testing is performed, concomitant CPT code(s)/charge(s) will apply.
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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

HAV Serology Interpretation: Key - Analyte present: + Analyte absent: - Test not indicated: TNI

Interpretation

HAV Ab, Total

HAV Ab, IgM

Susceptible/no indication of infection

-

TNI

Previously vaccinated against or infected with HAV

+

-

Acute infection

+

+

HBV Serology Interpretation: Key - Analyte present: + Analyte absent: - Test not indicated: TNI

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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