Chromosome Analysis, AFP, AChE, Amniotic Fluid With Reflex to Fetal Hemoglobin (Hb F)

CPT: 82013; 82106. If additional testing is performed, concomitant CPT codes/charges will apply.
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Test Includes

Analysis of fetal karyotype, AFP, and AChE to rule out chromosomal abnormalities and open neural tube defects (ONTD). The Hb F reflex is used to ascertain false elevations of amniotic fluid α-fetoprotein due to fetal blood contamination.


Special Instructions

State gestational age (in weeks) on the day the sample was drawn on the test request form. The patient's gestational age must be between 12 weeks and 24 weeks for interpretation of AF-AFP. AChE false-positive and false-negative results are more frequent at gestational ages of less than 13 weeks or greater than 24.9 weeks.

If prior NIPT studies have been performed, include copy of the report.


Expected Turnaround Time

9 - 12 days


Specimen Requirements


Specimen

Amniotic fluid


Volume

20 to 30 mL


Minimum Volume

10 mL


Container

Sterile plastic conical tube; do not use urine containers or tubes with rubber stoppers. Rubber is toxic to amniocytes.


Collection

Discard first 2 mL of fluid aspirated to avoid maternal cell contamination. Specimen is collected in a 20 mL sterile syringe and transferred aseptically to sterile tubes. The test request form is completed and accompanies specimen and miscellaneous slip to the laboratory.


Storage Instructions

Maintain specimen at room temperature. Do not freeze or refrigerate.


Stability Requirements

Temperature

Period

Room temperature

1 month


Causes for Rejection

Specimen found not to be amniotic fluid; gross contamination with red cells; frozen specimen; nonsterile container. Do not use urine containers or tubes with rubber stoppers; rubber is toxic to amniocytes.


Test Details


Use

Determine fetal karyotype; prenatal diagnosis of Down syndrome or other chromosomal abnormalities; analysis of midtrimester amniotic fluid for detection of open neural tube and ventral wall defects


Methodology

In situ cell culturing of amniocytes for the microscopic investigation of numerical and/or structural chromosome abnormalities; chemiluminescent immunoassay for AFP; isoelectric focusing (IEF); acrylamide gel electrophoresis


LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
511580 Chromosome, AFP/AChE/HbF, Amn 052138 Cells Counted 64095-3
511580 Chromosome, AFP/AChE/HbF, Amn 052139 Colonies 64096-1
511580 Chromosome, AFP/AChE/HbF, Amn 052140 Cells Analyzed 64092-0
511580 Chromosome, AFP/AChE/HbF, Amn 052141 Cells Karyotyped 64091-2
511580 Chromosome, AFP/AChE/HbF, Amn 052143 GTG Band Resolution Achieved 64093-8
511580 Chromosome, AFP/AChE/HbF, Amn 052144 Cytogenetic Diagnosis 62356-1
511580 Chromosome, AFP/AChE/HbF, Amn 052033 Cytogenetic Interpretation 62357-9
511580 Chromosome, AFP/AChE/HbF, Amn 052146 Specimen Type 48002-0
511580 Chromosome, AFP/AChE/HbF, Amn 052034 Director Review: 48672-0
511580 Chromosome, AFP/AChE/HbF, Amn 512123 PDF 51967-8
511580 Chromosome, AFP/AChE/HbF, Amn 010806 AFP, Amniotic Fluid N/A
511580 Chromosome, AFP/AChE/HbF, Amn 101352 AFP Value ug/mL 1832-5
511580 Chromosome, AFP/AChE/HbF, Amn 101360 AFP MoM 29253-2
511580 Chromosome, AFP/AChE/HbF, Amn 101379 Gestational Age(Wks) 49051-6
511580 Chromosome, AFP/AChE/HbF, Amn 101378 Interpretation 41273-4
511580 Chromosome, AFP/AChE/HbF, Amn 101376 Director 72486-4
511580 Chromosome, AFP/AChE/HbF, Amn 999500 Amniotic Fluid, AFP N/A
511580 Chromosome, AFP/AChE/HbF, Amn 510172 Acetylcholinesterase 30106-9
511580 Chromosome, AFP/AChE/HbF, Amn 510173 Interpretation 76479-5
511580 Chromosome, AFP/AChE/HbF, Amn 510177 ACHE N/A
511580 Chromosome, AFP/AChE/HbF, Amn 510170 Fetal Hemoglobin Testing N/A
Reflex Table for Interpretation
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 510206 AChE+Hb F 510172 Acetylcholinesterase 30106-9
Reflex Table for Interpretation
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 510206 AChE+Hb F 510180 Fetal Hemoglobin 28067-7
Reflex Table for Interpretation
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 510206 AChE+Hb F 510173 Interpretation 76479-5
Reflex Table for Fetal Hemoglobin Testing
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 510181 Fetal Hemoglobin 510180 Fetal Hemoglobin 28067-7

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