CDOS

Gynecologic Pap Test (Image-guided), Liquid-basedPreparation and Chlamydia/Gonococcus, NAA With Reflex toHuman Papillomavirus (HPV) (Aptima(R)) When ASC-U WithReflex to HPV Genotypes 16 and 18,45

Test Code: 199354

Performing Lab: LabCorp

CPT Code: 88175 001 87491 001 87591 001

Test Link (Copy)

Synonym

Image-guided pap with Ct/Ng reflexes to Aptima HPV when ASC-U with reflex to HPV genotypes 16 and 18,45.

Specimen Type

Cervical cells in ThinPrep(R) vial

Specimen Container

ThinPrep(R) vial

Volume

ThinPrep(R) vial

Minimum Volume

A minimum volume cannot be determined for the ThinPrep(R) vial because it varies depending on the cellularity of the specimen.

Specimen Handling

THINPREP(R) VIAL-BROOM OR BRUSH/SPATULA: BROOM-LIKE COLLECTION TECHNIQUE: Obtain a sample from the cervix using a broom-like device by inserting the brush portion into the cervical os and then rotate the brush five times. Rinse the collection device in the PreservCyt(R) solution by pushing the brush into the bottom of the vial 10 times, forcing the bristles to bend apart to release the cervical material. As a final step, twirl the brush between the thumb and forefinger vigorously to release additional cellular material. Discard the collection device. Tighten the cap on the ThinPrep(R) vial so that the torque line on the cap passes the torque line on the vial. BRUSH/SPATULA TECHNIQUE: Insert the brush into the endocervical canal until only the bottommost fibers are exposed. Slowly rotate the brush 1/4 to 1/2 turn in one direction. Do NOT over-rotate the brush. Then, rotate the brush in the PreservCyt(R) solution 10 times while pushing against the wall of the ThinPrep(R) vial. Swirl the brush vigorously to release additional material. Discard the brush. Obtain an adequate sample from the ectocervix using a plastic spatula. Swirl vigorously in the ThinPrep(R) vial 10 times and discard the spatula. Tighten the cap on the ThinPrep(R) container so that the torque line on the cap passes the torque line on the vial. OPTIONAL DEDICATED SPECIMEN FOR CHLAMYDIA AND GONOCOCCUS: Use the Gen-Probe(R) Aptima(R) swab collection kit. Clean the cervix using the larger, white-shafted swab supplied in the Gen-Probe(R) Aptima(R) swab collection kit and discard. Insert the smaller, blue-shafted swab into the cervix and rotate for 10 to 30 seconds to ensure good sampling. Carefully withdraw the blue-shafted swab, avoiding contact with the vaginal mucosa. Remove the cap from the swab specimen transport tube and immediately place the specimen collection swab into the transport tube. Break the swab shaft at the scoreline, using care to avoid splashing contents. Recap the swab specimen transport tube tightly.

Patient Prep

Patient should avoid douches 48 to 72 hours prior to examination. Specimen should not be collected during or shortly after menstrual period.

Unacceptable Conditions

Improper collection; inadequate specimen; improper labeling; specimen leaked in transit; quantity not sufficient for analysis; name discrepancies; specimen submitted on male patient; specimen submitted in vial that expired according to manufacturer's label; frozen specimen; SurePath(TM) vial. FOR PAP: liquid-based cytology specimen more than 21 days old. FOR HPV: specimen more than 21 days old in ThinPrep(R) vial. FOR CHLAMYDIA TRACHOMATIS AND NEISSERIA GONORRHOEAE: liquid-based cytology specimen more than seven days old; Aptima(R) specimen more than 60 days old; Gen-Probe(R) Aptima(R) collection tube with multiple swabs; white-shafted cleaning swab, or any swab other than the collection swab.

Temperature

Maintain specimen at room temperature. Specimens must be processed for testing within 21 days of collection for Pap.

Methodology

Image-guided liquid-based Pap test; nucleic acid amplification (NAA)

Result Code	Result Name	LOINC
191121	Test ordered:	UNLOINC
191108	DIAGNOSIS:	47528-5
191166	Interpretation	19764-0
191170	Category:	UNLOINC
191173	Recommendation:	UNLOINC
191169	Infection:	UNLOINC
191172	Adequacy:	UNLOINC
191111	Recommendation:	19773-1
191109	Specimen adequacy:	19764-0
191154	Source:	19763-2
191160	Clinician provided ICD9:	52797-8
191174	Clinician provided ICD10:	52797-8
191107	Clinical history:	22636-5
191124	Amended report:	UNLOINC
191110	Additional comment:	22638-1
191125	Addendum:	22639-9
191123	Maturation index:	UNLOINC
191112	Performed by:	19767-3
191128	QC reviewed by:	UNLOINC
191145	Diagnosis provided by:	UNLOINC
191113	Electronically signed by:	19769-9
191139	Special procedure:	UNLOINC
191129	Cytology history:	UNLOINC
191179	Previous history:	UNLOINC
191144	QA comment:	UNLOINC
019018	.	11546-9
191157	Pathologist provided ICD9:	52797-8
191175	Pathologist provided ICD10:	52797-8
190120	.	UNLOINC
190109	Note:	8251-1
L19300	Test Methodology:	47527-7
190119	.	UNLOINC
190119	.	UNLOINC
190119	.	UNLOINC
190119	.	UNLOINC
190119	.	UNLOINC
186114	Chlamydia, Nuc. Acid Amp	50387-0
186122	Gonococcus, Nuc. Acid Amp	50388-8
019054	PDF	11502-2
191167	Photomicrograph	UNLOINC
019030	.	UNLOINC
019031	Patient Counseling Report	UNLOINC

Reflex Order Code	Reflex Order Name
192555	Change IG Pap to LB Pap
507805	HPV, Aptima High 16/18,45
507825	HPV Genotypes 16/18,45
507805	HPV, Aptima High 16/18,45
507825	HPV Genotypes 16/18,45
507805	HPV, Aptima High 16/18,45
507825	HPV Genotypes 16/18,45
507805	HPV, Aptima High 16/18,45
507825	HPV Genotypes 16/18,45
507805	HPV, Aptima High 16/18,45
507805	HPV, Aptima High 16/18,45
507825	HPV Genotypes 16/18,45
507805	HPV, Aptima High 16/18,45
507825	HPV Genotypes 16/18,45
507805	HPV, Aptima High 16/18,45
507825	HPV Genotypes 16/18,45
507805	HPV, Aptima High 16/18,45
507825	HPV Genotypes 16/18,45
507805	HPV, Aptima High 16/18,45
507805	HPV, Aptima High 16/18,45
507825	HPV Genotypes 16/18,45
507805	HPV, Aptima High 16/18,45
507825	HPV Genotypes 16/18,45
507805	HPV, Aptima High 16/18,45
507825	HPV Genotypes 16/18,45
507805	HPV, Aptima High 16/18,45
507825	HPV Genotypes 16/18,45
507805	HPV, Aptima High 16/18,45
507805	HPV, Aptima High 16/18,45
507825	HPV Genotypes 16/18,45
507805	HPV, Aptima High 16/18,45
507825	HPV Genotypes 16/18,45
507805	HPV, Aptima High 16/18,45
507825	HPV Genotypes 16/18,45
507805	HPV, Aptima High 16/18,45
507825	HPV Genotypes 16/18,45
507805	HPV, Aptima High 16/18,45
507805	HPV, Aptima High 16/18,45
507825	HPV Genotypes 16/18,45
507805	HPV, Aptima High 16/18,45
507825	HPV Genotypes 16/18,45
507805	HPV, Aptima High 16/18,45
507825	HPV Genotypes 16/18,45
507805	HPV, Aptima High 16/18,45
507825	HPV Genotypes 16/18,45
507805	HPV, Aptima High 16/18,45

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