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Gynecologic Pap Test (Image-guided), Liquid-based Preparation and Herpes Simplex Virus (HSV) Types 1 and 2, NAA

CPT 87529(x2); 88175

Test Details

Methodology

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

Result Turnaround Time

4 - 6 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 Information

Related Documents

For more information, please view the literature below.

Genital Herpes Diagnosis: Technology and Test Options

Use

Diagnose primary or metastatic neoplasm; detect and type active HSV shedding

Special Instructions

Include date of birth, Social Security number (or other identification number), previous malignancy, drug therapy, radiation therapy, last menstrual period (LMP), postmenopausal patient (PMP), surgery (including surgical biopsies), exogenous hormones, abnormal vaginal bleeding, abnormal Pap results, IUD, and all other pertinent clinical information on the cytology test request form.

Note: In accordance with criteria established by CLIA, Pap tests will be referred for pathologist review if laboratory personnel suspect:

• Reactive or reparative cellular changes

• Atypical squamous or glandular cells of undetermined significance

• Cells in the premalignant or malignant category

In these cases, LabCorp will charge for the associated service. (Slides that are routinely reviewed by a pathologist for quality control purposes are not included.)

HSV NAA is a single test that both detects the presence of HSV DNA and determines which type is present in the positive samples. There is no mechanism, therefore, for testing for HSV-1 without simultaneously testing for HSV-2.

Limitations

Failure to obtain adequate ectocervical, endocervical, or vaginal cell population is suboptimal for evaluation. Excessive use of lubricating jelly on the vaginal speculum will interfere with cytologic examination and may lead to unsatisfactory Pap results. This test is intended for use as an aid in the diagnosis of herpes simplex virus (HSV) infections with active viral shedding; it also differentiates HSV-1 from HSV-2. Negative HSV NAA results indicate lack of viral shedding but do not confirm absence of previous infection.

Specimen Requirements

Specimen

Cervical cells collected by one of the methods described below.

Volume

ThinPrep® vial

Minimum Volume

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

Container

ThinPrep® vial

Collection Instructions

ThinPrep® 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® 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® 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 ¼ to ½ turn in one direction. Do not over-rotate the brush. Then, rotate the brush in the PreservCyt® solution 10 times while pushing against the wall of the ThinPrep® 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® vial 10 times and discard the spatula. Tighten the cap on the ThinPrep® container so that the torque line on the cap passes the torque line on the vial.

Storage Instructions

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

Patient Preparation

Patient should avoid douches 48 to 72 hours prior to examination. Specimen should not be collected during or shortly after menstrual period. Excessive use of lubricating jelly will interfere with cytologic examination.

Causes for Rejection

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 a vial that expired according to manufacturer's label; frozen specimen; SurePath™ vial. For Pap: liquid-based cytology specimen more than 21 days old. For HSV: liquid-based cytology specimen more than seven days old.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
198300 Pap IG, HSV 1/2 NAA 191121 Test ordered: N/A
198300 Pap IG, HSV 1/2 NAA 191108 DIAGNOSIS: 47528-5
198300 Pap IG, HSV 1/2 NAA 191166 Interpretation 19764-0
198300 Pap IG, HSV 1/2 NAA 191170 Category: N/A
198300 Pap IG, HSV 1/2 NAA 191173 Recommendation: N/A
198300 Pap IG, HSV 1/2 NAA 191169 Infection: N/A
198300 Pap IG, HSV 1/2 NAA 191172 Adequacy: N/A
198300 Pap IG, HSV 1/2 NAA 191111 Recommendation: 19773-1
198300 Pap IG, HSV 1/2 NAA 191109 Specimen adequacy: 19764-0
198300 Pap IG, HSV 1/2 NAA 191154 Source: 19763-2
198300 Pap IG, HSV 1/2 NAA 191160 Clinician provided ICD9: 52797-8
198300 Pap IG, HSV 1/2 NAA 191174 Clinician provided ICD10: 52797-8
198300 Pap IG, HSV 1/2 NAA 191107 Clinical history: 22636-5
198300 Pap IG, HSV 1/2 NAA 191124 Amended report: N/A
198300 Pap IG, HSV 1/2 NAA 191110 Additional comment: 22638-1
198300 Pap IG, HSV 1/2 NAA 191125 Addendum: 22639-9
198300 Pap IG, HSV 1/2 NAA 191123 Maturation index: N/A
198300 Pap IG, HSV 1/2 NAA 191112 Performed by: 19767-3
198300 Pap IG, HSV 1/2 NAA 191128 QC reviewed by: N/A
198300 Pap IG, HSV 1/2 NAA 191145 Diagnosis provided by: N/A
198300 Pap IG, HSV 1/2 NAA 191113 Electronically signed by: 19769-9
198300 Pap IG, HSV 1/2 NAA 191139 Special procedure: N/A
198300 Pap IG, HSV 1/2 NAA 191129 Cytology history: N/A
198300 Pap IG, HSV 1/2 NAA 191179 Previous history: N/A
198300 Pap IG, HSV 1/2 NAA 191144 QA comment: N/A
198300 Pap IG, HSV 1/2 NAA 019018 . 11546-9
198300 Pap IG, HSV 1/2 NAA 191157 Pathologist provided ICD9: 52797-8
198300 Pap IG, HSV 1/2 NAA 191175 Pathologist provided ICD10: 52797-8
198300 Pap IG, HSV 1/2 NAA 190120 . N/A
198300 Pap IG, HSV 1/2 NAA 190109 Note: 8251-1
198300 Pap IG, HSV 1/2 NAA 000000 Test Methodology: 47527-7
198300 Pap IG, HSV 1/2 NAA 188036 HSV 1 NAA 16130-7
198300 Pap IG, HSV 1/2 NAA 188037 HSV 2 NAA 16131-5
198300 Pap IG, HSV 1/2 NAA 191167 Photomicrograph N/A
198300 Pap IG, HSV 1/2 NAA 019030 . N/A
198300 Pap IG, HSV 1/2 NAA 019031 Patient Counseling Report N/A
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191121
Result Code NameTest ordered:
UofM
Result LOINCN/A
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191108
Result Code NameDIAGNOSIS:
UofM
Result LOINC47528-5
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191166
Result Code NameInterpretation
UofM
Result LOINC19764-0
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191170
Result Code NameCategory:
UofM
Result LOINCN/A
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191173
Result Code NameRecommendation:
UofM
Result LOINCN/A
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191169
Result Code NameInfection:
UofM
Result LOINCN/A
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191172
Result Code NameAdequacy:
UofM
Result LOINCN/A
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191111
Result Code NameRecommendation:
UofM
Result LOINC19773-1
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191109
Result Code NameSpecimen adequacy:
UofM
Result LOINC19764-0
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191154
Result Code NameSource:
UofM
Result LOINC19763-2
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191160
Result Code NameClinician provided ICD9:
UofM
Result LOINC52797-8
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191174
Result Code NameClinician provided ICD10:
UofM
Result LOINC52797-8
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191107
Result Code NameClinical history:
UofM
Result LOINC22636-5
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191124
Result Code NameAmended report:
UofM
Result LOINCN/A
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191110
Result Code NameAdditional comment:
UofM
Result LOINC22638-1
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191125
Result Code NameAddendum:
UofM
Result LOINC22639-9
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191123
Result Code NameMaturation index:
UofM
Result LOINCN/A
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191112
Result Code NamePerformed by:
UofM
Result LOINC19767-3
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191128
Result Code NameQC reviewed by:
UofM
Result LOINCN/A
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191145
Result Code NameDiagnosis provided by:
UofM
Result LOINCN/A
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191113
Result Code NameElectronically signed by:
UofM
Result LOINC19769-9
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191139
Result Code NameSpecial procedure:
UofM
Result LOINCN/A
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191129
Result Code NameCytology history:
UofM
Result LOINCN/A
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191179
Result Code NamePrevious history:
UofM
Result LOINCN/A
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191144
Result Code NameQA comment:
UofM
Result LOINCN/A
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code019018
Result Code Name.
UofM
Result LOINC11546-9
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191157
Result Code NamePathologist provided ICD9:
UofM
Result LOINC52797-8
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191175
Result Code NamePathologist provided ICD10:
UofM
Result LOINC52797-8
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code190120
Result Code Name.
UofM
Result LOINCN/A
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code190109
Result Code NameNote:
UofM
Result LOINC8251-1
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code000000
Result Code NameTest Methodology:
UofM
Result LOINC47527-7
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code188036
Result Code NameHSV 1 NAA
UofM
Result LOINC16130-7
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code188037
Result Code NameHSV 2 NAA
UofM
Result LOINC16131-5
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code191167
Result Code NamePhotomicrograph
UofM
Result LOINCN/A
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code019030
Result Code Name.
UofM
Result LOINCN/A
Order Code198300
Order Code NamePap IG, HSV 1/2 NAA
Order Loinc
Result Code019031
Result Code NamePatient Counseling Report
UofM
Result LOINCN/A
Reflex Table for Test Methodology:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 192555 Change IG Pap to LB Pap 000000 LBP CPT Code Automation 47527-7
Reflex 1
Order Code192555
Order NameChange IG Pap to LB Pap
Result Code000000
Result NameLBP CPT Code Automation
UofM
Result LOINC47527-7