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

Alkp > 104

Fractionate Alkaline Phosphatase (heated)

84078

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

Microbiology

 

*Flu Screen A and/or B

(VSFLU)

Negative

Flu PCR

87798

*Throat Screen for Strep

(TS)

Negative

Culture

87081

 

 

*Bacterial Culture

 

Positive

Identification

Susceptibility

87077

87106

87147

87149

87181

87184

83891

83898 (performed in DNA)

*Fungal Culture

Positive

Identification

Susceptibility

87106

87186

83891

83898 (performed in DNA)

*AFB Culture

Positive

Identification

87118

87149

83891

83898 (performed in DNA)

*Viral Culture

Positive

Identification

87253

87254

Toxicology

 

*Drugs of Abuse Screening

Any positive results

Confirmation

80102

Immunology

 

*HIV-1 / HIV-2 Antibody Screen

(HIV12)

Positive

HIV-1 Western Blot

86689

*Rapid HIV Antibody Testing

(RHIVNS)

test performed in Microbiology

Reactive

HIV-1 Western Blot

(performed in Davis Lab)

86689

*HIV-1 Western Blot

(HIVWB)

Negative or indeterminent

HIV-2 Western Blot

(send out)

86689

 

*Hepatitis B Surface Antigen

(HBSAG)

Positive

Hepatitis B Confirmation

87301

 

 

*Serum Syphillis Screen

(RPR)

Positive

RPRT

(Quantitation)

 

86593

 

 

*Serum Syphillis Screen (RPR)

Positive (1st time)

Treponemal Pallidum Antibody Assay

86787

*Serum Protein Electrophoresis

(SPEP)

Abnormal findings

IG Quantitation Plus

(QUANTP) Immunofixation (IMFIX)

82784

 

 

*Serum Protein Electrophoresis / Urine Protein Electrophoresis

(SPEP / URPEP)

Abnormal findings not resolved by QUANTP

Immunofixation

(IMFIX)

86334

*Hemoglobin Electrophoresis

(HGBEP)

Abnormal Hemoglobins

Hemoglobin Acid Electrophoresis

(ACIDHB)

83020

 

 

*Hemoglobin Electrophoresis

(HGBEP)

Abnormal findings not resolved by ACIDHB

Quantitation for

A2 or F

(send out)

83021

*G6PD Screen

Abnormal results

G6PD Quantitation

(send out)

83021

 

Cytology

 

Thin Prep Pap

ACS or AGS Diagnosis

Human Papillomavirus

(HPVD)

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 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 available

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

Diagnosis of stem cell or bone marrow transplant recipient

Irradiate

86945

*Transfuse red cells

Intrauterine  transfusion

Irradiate

86945

*Transfuse cellular products

Neonate < 4 Months

Irradiate

86945

*Transfuse granulocytes

None

Irradiate

86945

*Transfuse patient designated unit

None

Irradiate

86945

*Transfuse cellular product

Diagnosis of neuroblastoma

Irradiate

86945

 

*Transfuse cellular products

Diag. of congenital T-cell deficiency

Irradiate

86945

 

Reference Lab

 

*Insulin Antibody with reflex

Positive

Insulin Antibody Titer

86337

*Striated Muscle Antibody, Serum

Positive screen

Titer

86256

*Borrelia burgdorferi antibody (Lyme's Disease)

Positive or equivocal

Western Blot

86617 (x2)

 

 

*Islet Cell Antibody with Reflex to Titer

Positive screen

Antibody titer

86256 each Antibody

*Adrenal Antibodies with Reflex

Positive

Adrenal Antibodies Titer

86256

 

*Bartonella henselae &Bartonella quintana  (Cat Scratch Disease Antibodies) IgG, IgM screen with reflex

Positive

Bartonella henselae (IgG, IgM) & Bartonella quintana (IgG, IgM) titer

86611 (x4)

 

 

 

 

*Liver Kidney Microsomal Antibody Screen with reflex

Positive

Liver Kidney Microsomal Antibody Titer

86376

 

 

 

*Rickettsia rickettsii (Rocky Mountain Spotted Fever) Antibodies (IgG, IgM) with reflex to Titers

Positive

Rickettsia rickettsii (Rocky Mountain Spottd Fever) Antibodies (IgG, IgM) Titers

86757 (x2)

 

 

 

 

 

 

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

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

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

* Denotes Mandatory Reflex Testing