Test Includes

Screening for presence of high risk human papillomavirus types. Fourteen high risk HPV types are detected. Only types 16 and 18 are reported individually, other high risk types present are reported as positive for a type in the following panel (31, 33, 35, 39, 45, 51, 52 56, 58, 59, 66 and 68).

Turnaround Time

Results are reported within 2-3 days.

Use

Diagnose the presence and type of human papilloma virus in cervical cells. The common use of this test is screening and in the characterization of cellular atypical in samples from the anogenital tract.

Interpretive Data

HPV: Results are reported as "negative for high risk HPV DNA" or "positive for high risk HPV DNA". The specific HPV type is reported for 16DNA or 18DNA. 

Pap: See Thin Layer Cervical-Vaginal Pap Test (LAB1000) Test Directory page for Pap interpretive data.

Specimen Type

Cervical cells (SurePath™ collection vial)

Collection Containers

SurePath™ collection vial

Collection Instructions

SurePath™ vials must always have their label(s) placed horizontally around the container. Place the left edge of the label just to the right of the “Peel Here” tab and wrap the label horizontally around the SurePath™ vial, without covering the vial’s notch.Collection devices should be inserted into the large opening only, as demonstrated below.

Specimen Preparation

Do not process. Store at room temperature. Ensure labeling matches specifics in the collection instructions.

Unacceptable Conditions

Sample more than 30 days old when received for HPV testing.

Shipping Instructions

Deliver to lab within 30 days of collection at room temperature. 
Packing list: HPV-Pap Packing List to Molecular Diagnostics.

Containers

SurePath Collection Vial

Reference Interval

HPV: Negative for all HPV types. 

Pap: See Thin Layer Cervical-Vaginal Pap Test (LAB1000) Test Directory page for Pap reference interval.

Interpretive Data

HPV: Results are reported as "negative for high risk HPV DNA" or "positive for high risk HPV DNA". The specific HPV type is reported for 16DNA or 18DNA. 

Pap: See Thin Layer Cervical-Vaginal Pap Test (LAB1000) Test Directory page for Pap interpretive data.

CPT Disclaimer

The Current Procedural Terminology (CPT) Codes published in the M Health Fairview Test Directory are based on American Medical Association (AMA) guidelines and are provided for informational purposes only. CPT codes are provided only as guidance to assist clients with billing. CPT coding is the responsibility of the billing party. M Health Fairview Laboratories does not assume responsibility for billing errors due to reliance on the CPT codes listed in this Test Directory. Charges may vary due to reflexing, susceptibilities, specimen source, patient age, methodology requirements, etc..

Patient Price Inquiries

Requester Contact Information
Patient and UMP/FV Care Team Fairview Consumer Line at 612-672-1048
MRL Outreach Client dept-mrl-business-assessment@fairview.org
Research research@fairview.org

CPT Codes

CPT Qty HC Hospital PR Clinic Note
87624 1 3008762401 8762401 HC HPV HIGH RISK TYPES DNA CERVICAL

Methodology

Automated nucleic acid extraction, simultaneous amplification of HPV (E6/E7 oncogenes) and beta-globin, followed by real time detection of fluorescent labeled HPV and beta globin using specific oligonucleotide probes.

MRL Test Build

Test NameComponentRequiredDescriptionTypeLOINC
LAB8367  HPV and Gynecologic Cytology PanelOrderable 
 146413YAbnormal PAP or Colp BX in last 5 years?Prompt 
 146417 Previous PAP diagnosis:Prompt 
 146420YPertinent clinical history:Prompt 
 146426YType of PAP:Prompt 
 147144YDate of LMP (mm/dd/yyyy):Prompt 
 158972YCollection date(mm/dd/yyyy):Prompt 
 158973YCollection time:Prompt 
 SPT_1098Y Specimen type:Prompt 
 SRC_LAB6403YSpecimen source:Prompt 
 1230002034 Final DiagnosisResult 
 1230005225 Human Papilloma Virus 16 DNAResult77399-4
 1230005226 Human Papilloma Virus 18 DNAResult77400-0
 1230005227 Human Papilloma Virus OtherResult71431-1
LAB1000  Gynecologic Cytology PAP SmearOrderable 
 1230000994 AddendumResult35265-8
 1230000995 Addendum 2Result35265-8
 1230000996 Addendum 3Result35265-8
 1230000997 Addendum 4Result35265-8
 1230000998 Addendum 5Result35265-8
 1230001010 CommentResult22638-1
 1230001011 Clinical InformationResult22636-5
 1230001015 AmendmentResult22638-1
 1230001022 Interpretation GynResult 
 1230001023 Other FindingsResult 
 1230001024 Specimen AdequacyResult 
 1230001026 HPV ReflexResult 
 1230001027 LMP/Menopause DateResult 
 1230001028 Previous Abnormal?Result 
 1230001029 Previous Abnormal DiagnosisResult 
 1230008753 Technical Processing StatementResult22638-1
 1230011868 Associated HPV SpecimenResult 

Data Type / Multiple Choice Response

146413
Yes|No
146417
Text
146420
none|abnormal bleeding|pregnancy|post-partum|complete hysterectomy|post-menopausal|IUD|radiation|irregular bleeding
146426
Screening|Diagnostic
147144
Text
158972
Text
158973
Text
SPT_1098
Brushing|Swab
SRC_LAB6403
Cervix|Endocervical/cervical|Endocervical/vaginal|Endocervix|Vagina
146410
Yes if ASCUS|No
172520
Cervix|Vagina|Endocervical/cervical|Endocervical/vaginal|Endocervix

Contact

For questions regarding the test code Interface Map, please contact DEPT-LAB-CLIENT-INTERFACE@fairview.org
Ordering

Test Includes

Screening for presence of high risk human papillomavirus types. Fourteen high risk HPV types are detected. Only types 16 and 18 are reported individually, other high risk types present are reported as positive for a type in the following panel (31, 33, 35, 39, 45, 51, 52 56, 58, 59, 66 and 68).

Turnaround Time

Results are reported within 2-3 days.

Use

Diagnose the presence and type of human papilloma virus in cervical cells. The common use of this test is screening and in the characterization of cellular atypical in samples from the anogenital tract.

Interpretive Data

HPV: Results are reported as "negative for high risk HPV DNA" or "positive for high risk HPV DNA". The specific HPV type is reported for 16DNA or 18DNA. 

Pap: See Thin Layer Cervical-Vaginal Pap Test (LAB1000) Test Directory page for Pap interpretive data.
Collection & Processing

Specimen Type

Cervical cells (SurePath™ collection vial)

Collection Containers

SurePath™ collection vial

Collection Instructions

SurePath™ vials must always have their label(s) placed horizontally around the container. Place the left edge of the label just to the right of the “Peel Here” tab and wrap the label horizontally around the SurePath™ vial, without covering the vial’s notch.Collection devices should be inserted into the large opening only, as demonstrated below.

Specimen Preparation

Do not process. Store at room temperature. Ensure labeling matches specifics in the collection instructions.

Unacceptable Conditions

Sample more than 30 days old when received for HPV testing.

Shipping Instructions

Deliver to lab within 30 days of collection at room temperature. 
Packing list: HPV-Pap Packing List to Molecular Diagnostics.
Containers

Containers

SurePath Collection Vial

Result Interpretation

Reference Interval

HPV: Negative for all HPV types. 

Pap: See Thin Layer Cervical-Vaginal Pap Test (LAB1000) Test Directory page for Pap reference interval.

Interpretive Data

HPV: Results are reported as "negative for high risk HPV DNA" or "positive for high risk HPV DNA". The specific HPV type is reported for 16DNA or 18DNA. 

Pap: See Thin Layer Cervical-Vaginal Pap Test (LAB1000) Test Directory page for Pap interpretive data.
Administrative

CPT Disclaimer

The Current Procedural Terminology (CPT) Codes published in the M Health Fairview Test Directory are based on American Medical Association (AMA) guidelines and are provided for informational purposes only. CPT codes are provided only as guidance to assist clients with billing. CPT coding is the responsibility of the billing party. M Health Fairview Laboratories does not assume responsibility for billing errors due to reliance on the CPT codes listed in this Test Directory. Charges may vary due to reflexing, susceptibilities, specimen source, patient age, methodology requirements, etc..

Patient Price Inquiries

Requester Contact Information
Patient and UMP/FV Care Team Fairview Consumer Line at 612-672-1048
MRL Outreach Client dept-mrl-business-assessment@fairview.org
Research research@fairview.org

CPT Codes

CPT Qty HC Hospital PR Clinic Note
87624 1 3008762401 8762401 HC HPV HIGH RISK TYPES DNA CERVICAL

Methodology

Automated nucleic acid extraction, simultaneous amplification of HPV (E6/E7 oncogenes) and beta-globin, followed by real time detection of fluorescent labeled HPV and beta globin using specific oligonucleotide probes.
Interface Mapping

MRL Test Build

Test NameComponentRequiredDescriptionTypeLOINC
LAB8367  HPV and Gynecologic Cytology PanelOrderable 
 146413YAbnormal PAP or Colp BX in last 5 years?Prompt 
 146417 Previous PAP diagnosis:Prompt 
 146420YPertinent clinical history:Prompt 
 146426YType of PAP:Prompt 
 147144YDate of LMP (mm/dd/yyyy):Prompt 
 158972YCollection date(mm/dd/yyyy):Prompt 
 158973YCollection time:Prompt 
 SPT_1098Y Specimen type:Prompt 
 SRC_LAB6403YSpecimen source:Prompt 
 1230002034 Final DiagnosisResult 
 1230005225 Human Papilloma Virus 16 DNAResult77399-4
 1230005226 Human Papilloma Virus 18 DNAResult77400-0
 1230005227 Human Papilloma Virus OtherResult71431-1
LAB1000  Gynecologic Cytology PAP SmearOrderable 
 1230000994 AddendumResult35265-8
 1230000995 Addendum 2Result35265-8
 1230000996 Addendum 3Result35265-8
 1230000997 Addendum 4Result35265-8
 1230000998 Addendum 5Result35265-8
 1230001010 CommentResult22638-1
 1230001011 Clinical InformationResult22636-5
 1230001015 AmendmentResult22638-1
 1230001022 Interpretation GynResult 
 1230001023 Other FindingsResult 
 1230001024 Specimen AdequacyResult 
 1230001026 HPV ReflexResult 
 1230001027 LMP/Menopause DateResult 
 1230001028 Previous Abnormal?Result 
 1230001029 Previous Abnormal DiagnosisResult 
 1230008753 Technical Processing StatementResult22638-1
 1230011868 Associated HPV SpecimenResult 

Data Type / Multiple Choice Response

146413
Yes|No
146417
Text
146420
none|abnormal bleeding|pregnancy|post-partum|complete hysterectomy|post-menopausal|IUD|radiation|irregular bleeding
146426
Screening|Diagnostic
147144
Text
158972
Text
158973
Text
SPT_1098
Brushing|Swab
SRC_LAB6403
Cervix|Endocervical/cervical|Endocervical/vaginal|Endocervix|Vagina
146410
Yes if ASCUS|No
172520
Cervix|Vagina|Endocervical/cervical|Endocervical/vaginal|Endocervix

Contact

For questions regarding the test code Interface Map, please contact DEPT-LAB-CLIENT-INTERFACE@fairview.org
Private Details

Test Detail

Processing Key


See Processing Key "Special" Definitions document for *SPECIAL* definition.
Performing Lab
UMMC East Bank
Department
UM Molecular Diagnostics (M)
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