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HBV Baseline Evaluation, HCV Direct-acting Antivirals
CPT:
86704; 86706; 87340. If reflex testing is performed, concomitant CPT codes/charges will apply.
Synonyms
- Hepatitis
Test Includes
Hepatitis B Surface Antigen (HBsAg) Screen [006510]; Hepatitis B Surface Antibody (anti-HBs) [006395]; Hepatitis B Core Antibody, Total (anti-HBc) [006718].
Reflex of HBsAg + to: HBV quant DNA [551610].
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 - 5 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
7.5 mL
Minimum Volume
2.9 mL (Note: This volume does not allow for repeat testing.)
Container
Gel-barrier tube, red top tube, or lavender-top (EDTA) tube
Collection
Two samples must be submitted.
HBsAg, anti-HBs, anti-HBc Total: If tube other than a gel-barrier tube is used, transfer separated serum or plasma to a plastic transport tube.
HBV DNA: Centrifuge sample within 24 hours of collection. Transfer serum/plasma to a screw-cap polypropylene transport tube. Ship frozen (preferred). Plasma from a PPT can be frozen in situ.
To avoid delays in turnaround time when requesting multiple tests on frozen samples, please submit a separate frozen specimen for each test requested.
Storage Instructions
HBsAg, anti-HBs, anti-HBc Total: Room temperature (preferred) up to 14 days. Refrigerated up to 14 days. Frozen up to 14 days.
HBV DNA: Frozen (preferred) up to 12 weeks. Refrigerated up to 6 days. Room temperature up to 24 hours.
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
Risk assessment and management of HBV infection status in patients prior to initiation of HCV treatment with direct-acting antiviral agents.
Limitations
The HBV quantitative real-time PCR assay has a quantitative range of 10 to 1,000,000,000 IU/mL.
Methodology
Immunochemiluminometric assay (ICMA)
References
US Food and Drug Administration. FDA Drug Safety Communication: FDA warns about the risk of hepatitis B reactivating in some patients treated with direct-acting antivirals for hepatitis C. FDA web site: https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-warns-about-risk-hepatitis-b-reactivating-some-patients-treated. Published Oct. 4, 2016. Accessed April 7, 2017.
Whitsett M, Feldman DM, Pan CQ. Risk assessment and management of hepatitis B reactivation from direct-acting antivirals for hepatitis C. Liver Research. 2019 Jun;3(2):75-79. doi.org/10.1016/j.livres.2019.03.002
LOINC® Map
| Order Code | Order Code Name | Order Loinc | Result Code | Result Code Name | UofM | Result LOINC |
|---|---|---|---|---|---|---|
| 144547 | HBV Baseline | 006510 | HBsAg Screen | 5196-1 | ||
| 144547 | HBV Baseline | 006408 | Hep B Surface Ab, Qual | 22322-2 | ||
| 144547 | HBV Baseline | 006718 | Hep B Core Ab, Tot | 13952-7 |
| 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 HBsAg Screen | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 551610 | HBV Real-Time PCR, Quant | 551629 | HBV IU/mL | IU/mL | 42595-9 |
| Reflex 2 | 551595 | HBV Real-Time PCR, Quant | 551628 | HBV IU/mL | IU/mL | 42595-9 |
| Reflex Table for HBsAg Screen | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 551610 | HBV Real-Time PCR, Quant | 551629 | HBV IU/mL | IU/mL | 42595-9 |
| Reflex 2 | 551595 | HBV Real-Time PCR, Quant | 551596 | log10 HBV IU/mL | log10 IU/mL | 48398-2 |
| Reflex Table for HBsAg Screen | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 551610 | HBV Real-Time PCR, Quant | 551597 | log10 HBV IU/mL | log10 IU/mL | 48398-2 |
| Reflex Table for HBsAg Screen | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 551610 | HBV Real-Time PCR, Quant | 551724 | Test Information: | 19147-8 | |
| Reflex Table for HBsAg Screen | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 144405 | HBsAg Confirmation | 016105 | HBsAg Confirmation | 7905-3 | |
| Reflex 2 | 551610 | HBV Real-Time PCR, Quant | 551629 | HBV IU/mL | IU/mL | 42595-9 |
| Reflex 3 | 551595 | HBV Real-Time PCR, Quant | 551628 | HBV IU/mL | IU/mL | 42595-9 |
| Reflex Table for HBsAg Screen | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 144405 | HBsAg Confirmation | 016105 | HBsAg Confirmation | 7905-3 | |
| Reflex 2 | 551610 | HBV Real-Time PCR, Quant | 551629 | HBV IU/mL | IU/mL | 42595-9 |
| Reflex 3 | 551595 | HBV Real-Time PCR, Quant | 551596 | log10 HBV IU/mL | log10 IU/mL | 48398-2 |
| Reflex Table for HBsAg Screen | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 144405 | HBsAg Confirmation | 016105 | HBsAg Confirmation | 7905-3 | |
| Reflex 2 | 551610 | HBV Real-Time PCR, Quant | 551597 | log10 HBV IU/mL | log10 IU/mL | 48398-2 |
| Reflex Table for HBsAg Screen | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 144405 | HBsAg Confirmation | 016105 | HBsAg Confirmation | 7905-3 | |
| Reflex Table for HBsAg Screen | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 144405 | HBsAg Confirmation | 016105 | HBsAg Confirmation | 7905-3 | |
| Reflex 2 | 551610 | HBV Real-Time PCR, Quant | 551724 | Test Information: | 19147-8 | |
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