| Test Code |
Procedure |
| 504006 |
CAHDetxTM by PCR |
| 128404 |
Chlamydia trachomatis DNA by PCR
- Pap reflex testing |
| |
Chlamydia trachomatis/GC Amplified Probe - see GC/Chlamydia Trachomatis DNA Detection by PCR |
| 605070 |
Cytomegalovirus DNA by PCR, Quantitative *RUO* |
| 605064 |
Epstein-Barr Virus DNA by PCR |
| 120736 |
Factor II Gene Mutation (Prothrombin G20210A) |
| 120719 |
Factor V Leiden Mutation |
| 129200 |
Fragile X Syndrome |
| 609505 |
GC/CT DNA by PCR |
| 128403 |
GC/CTDetxTM by PCR
(Neisseria gonorrhea and Chlamydia trachomatis detection)
- Pap reflex testing |
| 606623 |
GC DNA by PCR (Neisseria gonorrhoeae) |
| 128405 |
GC DNA by PCR (Neisseria gonorrhoeae)
- Pap reflex testing |
| 601095 |
HCV ExactTM (Hepatitis C Virus RNA, Quantitiative Viral Load) |
| 607029 |
Hepatitis B Virus DNA by PCR, Qualitative |
| 600045 |
Hepatitis C Virus Genotyping by CDX Taqman |
| 605061 |
Hepatitis C Virus RNA by PCR, Qualitative |
| 129150 |
Hereditary Hemochromatosis (H63D, C282Y and S65C mutations) |
| |
HIV-1 Genotyping - see 608890 - ViraMapTM |
| 608881 |
HIV-1 RNA by PCR, Quantitative Viral Load |
| 608882 |
HIV-1 RNA by PCR, Quantitative Viral Load, Ultrasensitive |
| 128400 |
HPVDetxTM by PCR
(Comprehensive detection and genotyping for all human papillomavirus risk levels)
- Pap reflex testing
|
| 128450 |
HPVDetxTM High Risk Assessment by PCR
(High risk detection and genotyping for human papillomavirus )
- Pap reflex testing
|
| 128402 |
HPV TriTectTM by PCR
(HPVDetxTM, Neisseria gonorrhea, Chlamydia trachomatis)
- Pap reflex testing
Note: HPV positive samples will reflex for genotyping adding additional CPT codes |
| 128452 |
HPV TriTectTM High Risk Assessment by PCR
(HPVDetxTM High Risk, Neisseria gonorrhea, Chlamydia trachomatis)
- Pap reflex testing
Note: HPV positive samples will reflex for genotyping adding additional CPT codes |
| 300734 |
HR2 Haplotype (Factor V HR2), A4070G Polymorphism |
| |
Human Papilloma Virus (HPV) Pap Reflex Testing - see 128400 - HPVDetxTM |
| 605068 |
Lyme Disease DNA by PCR (Borrelia burgdorferi) |
| 120740 |
MTHFR A1298C Mutation
(Methylene Tetrahydrofolate Reductase) |
| 120733 |
MTHFR C677T Mutation
(Methylene Tetrahydrofolate Reductase) |
| 129300 |
MTHFR Reflex
(Heterozygous reflexes to MTHFR A1298C) |
| |
Neisseria gonorrhea - see various codes - GC |
| 300933 |
Oral Contraceptive/Hormone Replacement Therapy Thrombotic Risk Evaluation
(Antithrombin Activity, Factor II Gene Mutation (Prothrombin G20210A), Factor V Leiden, Protein C Activity, Protein S Antigen Free) |
| 129100 |
Plasminogen Activator Inhibitor-1, 4G/5G Genotyping *RUO* (PAI-1 polymorphism) |
| |
Platelet Specific Antigen PLA1 (HPA-1a) - see 300531 - HPA-1a (PLA 1 Platelet Antigen Genotyping PLA 2 Polymorphism Detection) |
| |
Platelet Specific Antigen-2 (PLA2)
Polymorphism (HPA-1b) - see 300531- HPA-1a (PLA 1 Platelet Antigen Genotyping PLA 2 Polymorphism Detection)
|
| |
Prothrombin Gene 20210A Mutation
(Factor II Mutation) - see 120736 - Factor II Gene Mutation (Prothrombin G20210A) |
| 300915 |
Recurrent Miscarriage/Fetal Demise /Obstetric Complications Evaluation
(APTT, Anticardiolipin Antibody (IgG, IgM, IgA), Antiphosphatidylserine (IgG, IgM), Antithrombin Activity, Beta-2 Glycoprotein I Antibody (IgG, IgM, IgA), DRVVT, Factor II Gene Mutation (Prothrombin G20210A), Factor V Mutation (Leiden), Hexagonal Phospholipid Neutralization, Homocysteine, Protein C Activity, Protein S Antigen Free.)
|
| 504005 |
SHOX-DNA-DxTM |
| 129260 |
ThrombAssureTM (Factor II Gene Mutation (Prothrombin G20210A) , Factor V Leiden Mutation) |
| 129250 |
ThrombAssure PlusTM (Factor II Gene Mutation (Prothrombin G20210A), Factor V Leiden Mutation, HR2 Haplotype (A4070G), MTHFR C677T) |
| 300931 |
ThrombAssure EnhancedTM
(Factor II Gene Mutation (Prothrombin G20210A), Factor V Leiden Mutation, Anticardiolipin Antibody (IgG, IgM, IgA), Antithrombin Activity, DRVVT, Hexagonal Phospholipid Neutralization, Homocysteine, Protein C Activity, Protein S Antigen Free) |
| 300932 |
ThrombAssure InheritedTM
(Factor II Gene Mutation (Prothrombin G20210A), Factor V Leiden Mutation, Antithrombin Activity Plasma, Protein C Activity, Protein S Antigen Free) |
| 300901 |
Venous Thrombosis (Hypercoagulability) Evaluation
(Activated Protein C Resistance, Anticardiolipin Antibody (IgG, IgM), Antithrombin Activity, Factor II Gene Mutation (Prothrombin G20210A), DRVVT, Hexagonal Phospholipid Neutralization, Homocysteine, Protein C Activity (chromogenic), Protein S Antigen Free, Factor VIII Activity)
Note: Reflex to Factor V Leiden if APCR is abnormal |
| 300905 |
Venous Thrombosis Evaluation Appended (Factor IX Activity, Factor XI Activity, Fibrinogen Activity, Fibrinogen Antigen, HR2 Haplotype (A4070G), Lipoprotein (a), Plasminogen Activity) |
| 300903 |
Venous Thrombosis (Hypercoagulability) Evaluation for Patients on Oral Anticoagulant Therapy
(Activated Protein C Resistance, Anticardiolipin Antibody (IgG, IgM), Antithrombin Activity, Factor II Gene Mutation (Prothrombin G20210A), DRVVT, Hexagonal Phospholipid Neutralization, Homocysteine, Protein C Antigen, Protein S Antigen Total, Factor VII Antigen *RUO*, Factor VIII Activity, Protein C Antigen/Factor VII Antigen Ratio *RUO*, Protein S Antigen/Factor VII Antigen Ratio *RUO*
Note: Reflex to Factor V Leiden if APCR is abnormal. |
| 608890 |
ViraMapTM(HIV-1 Genotype, DNA Sequencing) |
