Find Locations
For hours, walk-ins and appointments.Viral Hepatitis Screening and Diagnosis (HBV, HCV)
CPT:
86704; 86706; 86803; 87340
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 C Virus (HCV) Antibody with reflex to Quantitative Real-time PCR [144050]
Special Instructions
If reflex test is performed, additional charges/CPT code(s) 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
4 mL
Minimum Volume
2 mL
Container
Gel-barrier tube, plasma preparation tube (PPT), serum transfer tube, EDTA-plasma transfer tube
Collection
Centrifuge sample within 24 hours of collection. If tube other than a gel-barrier tube is used, or if sample will be shipped frozen, transfer separated serum/plasma to a screw-cap polypropylene transport tube.
Ship refrigerated (preferred) or frozen.
Storage Instructions
Refrigerated (preferred)
HBV: stable 14 days at room temperature, refrigerated (preferred), and frozen
HCV: stable 24 hours at room temperature, 6 days refrigerated or 6 weeks frozen
Causes for Rejection
Heat-inactivated specimens; cord blood; cadaveric specimens; or body fluids other than serum or EDTA plasma; gross hemolysis; excessive lipemia; improper labeling; frozen gel-barrier tube
Test Details
Use
Aid in the diagnosis of viral hepatitis due to infection with HBV and/or HCV.
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) (see individual tests for methodologies)
Additional Information
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 | + | - | + | - |
Interpretation unclear* | - | - | + | ± |
Interpretation | HCV Ab | HCV RNA, NAA |
|---|---|---|
*For persons who might have been exposed to HCV within the past 6 months, testing for HCV RNA or follow-up testing for HCV antibody should be performed. For persons who are immunocompromised, testing for HCV RNA should be performed. **Repeat HCV-RNA testing if the person tested is suspected to have had HCV exposure within the past 6 months or has clinical evidence of HCV disease. | ||
No HCV antibody detected, no indication of infection* | - | TNI |
HCV antibody detected but no evidence of current infection** | + | - |
HCV antibody and viral RNA detected consistent with current infection | + | + |
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
American Association for the Study of Liver Diseases, Infectious Diseases Society of America. HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C: HCV Testing and Linkage to Care. HCVGuidelines.org web site: https://www.hcvguidelines.org/evaluate/testing-and-linkage. Accessed June 2021.
Centers for Disease Control and Prevention. Hepatitis B. CDC web site: www.cdc.gov/hepatitis/hbv/index.htm. Accessed May 2021.
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 |
|---|---|---|---|---|---|---|
| 144025 | Viral Hepatitis HBV, HCV | 92889-5 | 006510 | HBsAg Screen | 5196-1 | |
| 144025 | Viral Hepatitis HBV, HCV | 92889-5 | 006408 | Hep B Surface Ab, Qual | 22322-2 | |
| 144025 | Viral Hepatitis HBV, HCV | 92889-5 | 006718 | Hep B Core Ab, Tot | 13952-7 | |
| 144025 | Viral Hepatitis HBV, HCV | 92889-5 | 144035 | HCV Ab | 40726-2 |
| 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 HCV Ab | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 144030 | Interpretation: | 144030 | Interpretation: | 13955-0 | |
| Reflex Table for HCV Ab | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 550362 | HCV RT-PCR, Quant (Non-Graph) | 550338 | Hepatitis C Quantitation | IU/mL | 11011-4 |
| Reflex 2 | 550352 | HCV RNA (International Units) | 550353 | HCV RNA (International Units) | IU/mL | 11011-4 |
| Reflex Table for HCV Ab | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 550362 | HCV RT-PCR, Quant (Non-Graph) | 550338 | Hepatitis C Quantitation | IU/mL | 11011-4 |
| Reflex 2 | 550352 | HCV RNA (International Units) | 550354 | HCV log10 | log10 IU/mL | 38180-6 |
| Reflex Table for HCV Ab | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 550362 | HCV RT-PCR, Quant (Non-Graph) | 550339 | HCV log10 | log10 IU/mL | 38180-6 |
| Reflex Table for HCV Ab | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 550362 | HCV RT-PCR, Quant (Non-Graph) | 550314 | Test Information: | 19147-8 | |
| Reflex Table for HCV Ab | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 550362 | HCV RT-PCR, Quant (Non-Graph) | 550396 | Interpretation: | 62365-2 | |
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