MEDICAL CENTER - NORTH IOWA
LABORATORY
REFLEX TESTING

INITIAL TEST

CPT CODE

REFLEX CRITERIA

REFLEX TEST(S)

CPT CODE

ANA

86038

Positive

ANA Pattern & Titer

86039 (Out patients)

ANA Titer

86039

>160

DNA

86225

ASO

86063

Positive

ASO Titer

86060 (Out patients)

Brucellosis Titer

<20

Brucellosis IgG

CBC

85025

Established Criteria

Cell Morphology

85007

CK

82550

>200 IU/L if Female
> 235 IU/L if Male

CKMB

82553

Cryptococcal Antigen

87449/87102

Detected

Cryptococcal Titer

Cytoplasmic Neutrophil Antibodies, Serum

86255-screen
86256-titer (if appropriate)

Positive

Myeloperoxidase Antibodies, Serum
Autoantibodies to Proteinase 3, Serum

83520
83516

FDP (serum)

85362

Positive & no latex RA in last 7 days

Latex RA

86430

Fecal Leukocytes

87205

Positive

Fecal Leukocytes Differential

Hepatitis B Surface Antigen

87340

Positive

Hepatitis B Supplemental Tests

87341

Hepatitis C Antibody

86803

Positive

HCV RNA by RT-PCR

87522

HIV

86703

Detected

HIV Supplemental
(Western Blot)

86702, 86703, 86689

HIV Supplemental

86702
86703
86689

Indeterminate

HIV Supplemental

81758

HIV (IFA)

81758

Negative

HIVZ (EIA)

86702

Latex RA

86430

Positive

Latex RA Titer

86431 (Out patients)

Mixing Tests

85610
85730

Established Criteria

PT and/or PTT mixing test

85611 PTR mixing test
85732 PTT mixing test

Syphilis IgG Ab 86592 Positive RPR 86592

Thin Prep Pap Smear

88142

Atypical cells of unknown significance (ASCUS)

HPV

87621

Urinalysis/Microscopic 81001

Bacteria >/=2+/hpf

WBC >/=6/hpf

Epithelial Cells </=5/hpf

Urine culture for inpatients with the exception of 3W and 5E (ER hold, if admitted URNC ordered)  

R:\clerical\reference\reflex chart.doc
4/6/06