Gynecologic Pap Test (Image-guided), Liquid-based Preparation With Maturation Index

CPT: 88155; 88175
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Test Details

Synonyms

  • Pap Test With Maturation Index, Image-guided

Limitations

Failure to obtain a vaginal cell population renders the specimen unsatisfactory for evaluation. Excessive use of lubricating jelly on the vaginal speculum will interfere with cytologic examination and may lead to unsatisfactory Pap results.

Methodology

Image-guided liquid-based Pap test

Specimen Requirements

Specimen

Vial with PreservCyt® solution; ThinPrep®; SurePath™; preservative fluid or vial with CytoRich™ fixative

Volume

Entire vial

Minimum Volume

1 mL

Container

ThinPrep® vial or SurePath™ vial

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 on the vaginal speculum will interfere with cytologic examination.

Collection

Use the cervix brush to obtain cells from the upper third of the lateral vaginal wall. Then, rotate the brush in the PreservCyt® solution 10 times while pushing against the wall of the vial. Swirl the brush vigorously to release additional material. Discard the brush. Tighten the cap on the PreservCyt® solution container so that the torque line on the cap passes the torque line on the vial. Record the patient's name and ID number on the vial and place it and the test request form in a specimen bag for transport to the laboratory.

When doing the TriPath SurePath™ method, the cervix brush (broom) must be used before being placed in the CytoRich™ preservative fluid collection vial. Also, the cervix brush and Wallach brush may be used in obtaining a ThinPrep® specimen, but the brush is rinsed vigorously in the vial and discarded; the brush head is not placed in the ThinPrep® PreservCyt® vial.

Storage Instructions

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

Causes for Rejection

Improperly labeled vial; specimen more than 21 days old (from collection date) in liquid-based preservative; specimen submitted in vial that expired according to manufacturer's label; frozen specimen

Clinical Information

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.)

References

Hutchinson ML, Cassin CM, Ball HG 3rd. The efficacy of an automated preparation device for cervical cytology. Am J Clin Pathol. 1991 Sep; 96(3):300-305. 1877527
Hutchinson ML, Isenstein LM, Goodman A, et al, Homogeneous sampling accounts for the increased diagnostic accuracy using the ThinPrep® Processor. Am J Clin Pathol. 1994 Feb; 101(2):215-219. 8116578
Joseph MG, Cragg F, Wright VC, Kontozoglou TE, Downing P, Marks FR. Cyto-histological correlates in a colposcopic clinic: A 1-year prospective study. Diagn Cytopathol. 1991; 7(5):477-481. 1954825
Wilbur DC, Cibas ES, Merritt S, James LP, Berger BM, Bonfiglio TA. ThinPrep® Processor. Clinical trials demonstrate an increased detection rate of abnormal cervical cytologic specimens. Am J Clin Pathol. 1994 Feb; 101(2):209-214.8116577

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
193069 Pap IG, w Mat Indx 191121 Test ordered: N/A
193069 Pap IG, w Mat Indx 191158 ****************************** N/A
193069 Pap IG, w Mat Indx 191108 DIAGNOSIS: 22637-3
193069 Pap IG, w Mat Indx 191166 Interpretation N/A
193069 Pap IG, w Mat Indx 191170 Category: N/A
193069 Pap IG, w Mat Indx 191173 Recommendation: N/A
193069 Pap IG, w Mat Indx 191169 Infection: N/A
193069 Pap IG, w Mat Indx 191172 Adequacy: N/A
193069 Pap IG, w Mat Indx 191111 Recommendation: 19773-1
193069 Pap IG, w Mat Indx 191109 Specimen adequacy: 19764-0
193069 Pap IG, w Mat Indx 191159 ****************************** N/A
193069 Pap IG, w Mat Indx 191154 Source: 19763-2
193069 Pap IG, w Mat Indx 191160 Clinician provided ICD9: 52797-8
193069 Pap IG, w Mat Indx 191174 Clinician provided ICD10: 52797-8
193069 Pap IG, w Mat Indx 191107 Clinical history: 22636-5
193069 Pap IG, w Mat Indx 191124 Amended report: N/A
193069 Pap IG, w Mat Indx 191110 Additional comment: 22638-1
193069 Pap IG, w Mat Indx 191125 Addendum: 22639-9
193069 Pap IG, w Mat Indx 191123 Maturation index: N/A
193069 Pap IG, w Mat Indx 191112 Performed by: 19767-3
193069 Pap IG, w Mat Indx 191128 QC reviewed by: N/A
193069 Pap IG, w Mat Indx 191145 Diagnosis provided by: N/A
193069 Pap IG, w Mat Indx 191113 Electronically signed by: 19769-9
193069 Pap IG, w Mat Indx 191139 Special procedure: N/A
193069 Pap IG, w Mat Indx 191129 Cytology history: N/A
193069 Pap IG, w Mat Indx 191179 Previous history: N/A
193069 Pap IG, w Mat Indx 191144 QA comment: N/A
193069 Pap IG, w Mat Indx 019026 . 19765-7
193069 Pap IG, w Mat Indx 191157 Pathologist provided ICD9: 52797-8
193069 Pap IG, w Mat Indx 191175 Pathologist provided ICD10: 52797-8
193069 Pap IG, w Mat Indx 190120 . N/A
193069 Pap IG, w Mat Indx 190109 Note: N/A
193069 Pap IG, w Mat Indx 000000 Test Methodology: 47527-7
193069 Pap IG, w Mat Indx 000000 Maturation Index CPT Code Auto N/A
193069 Pap IG, w Mat Indx 191167 Photomicrograph N/A
193069 Pap IG, w Mat Indx 019030 . N/A
193069 Pap IG, w Mat Indx 019031 Patient Counseling Report N/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 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

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