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24886 Cytology, Pap, Liquid Prep w/HPV + HPV Genotyping Reflex

Cytology, Pap, Liquid Prep w/HPV + HPV Genotyping Reflex
Test Code: Pathology GYN Request - Liquid Prep w/HPV + Geno
Synonyms/Keywords
​​​​Pap and HPV Co-Testing​ + HPV Genotyping Reflex
Useful For
The cervicovaginal smear is a test for the detection of premalignant, cellular changes, which are precursors to carcinoma of the cervix.  The conventional pap smear, when used as part of a regular screening program has been credited with reducing the incidence of cervical cancer worldwide.  
​
The Thin-Prep pap test has been approved by the U.S. Food and Drug Administration as a replacement for the conventional pap smear and is endorsed by the College of American Pathologists as a method to improve the accuracy of pap examinations.   The Thin Prep pap test improves detection of low-grade and more severe lesions.  By improving detection, disease can be identified at an earlier stage when it is more easily and cost-effectively treated. 
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​ ThinPrep vial​ ​ 20 mL​ ​
 ​
Collection Processing Instructions
Obtain an adequate sampling from the ectocervix using a plastic spatula. Immediately rinse the spatula into the ThinPrep PreservCyt Solution vial by swirling the spatula vigorously in the vial 10 times. Discard the spatula. Obtain an adequate sampling from the endocervix using an endocervical brush device. Insert the brush into the cervix until only the bottom-most fibers are exposed. Slowly rotate 1/4 to 1/2 turn in one direction. DO NOT OVER-ROTATE. Immediately rinse the brush in the PreservCyt Solution by rotating the device in the solution 10 times while pushing against the PreservCyt vial wall. Swirl the brush vigorously to further release material. Discard the brush. Tighten the cap so that the torque line on the cap passes the torque line on the vial.
 
Record the patient name and medical record number on the vial. ​

NOTE: Self-collected pap tests are not FDA approved and will be rejected by the laboratory. 
Specimen Stability Information
Specimen Type Temperature Time
ThinPrep​ Room Temperature​ 4 Weeks​
Rejection Criteria
See:  HUMAN PAPILLOMAVIRUS (HPV) and HPV GENOTYPING
​Frozen specimen
​Self-collected specimen

Interference
Lubricants may increase the risk of contaminating and obscuring the cellular sample. When collecting a specimen, warm water is suggested to lubricate and warm the speculum. If a lubricant must be utilized, a sparing application to the outer portion of the speculum, with avoidance of the tip, is recommended. The following lubricant brands are acceptable to use with the PreServCyt S​olution: Surgilube, CerviLube or Pap Test Lubricating Jelly
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield - Cytopathology​ Monday-Friday​ 3 day​s ThinPrep, Light Microscopy​
Test Information
For additional HPV information, see the Human Papillomavirus (HPV).

For additional HPV Genotyping information, see ​HPV-Human Papillomavirus Genotyping 16,18/45(NAM)
 
This fulfills the 2012 ACOG Pap/HPV Co-Testing Guideline Recommendations.​

Include specimen source, pertinent patient history and clinical informatio​n along with the appropriate ICD-10 code on the electronic order or test requisition form. 

For Collection Techniques/Instructions see:

•          Endocervical Brush/Spatula Collection Guide

•          Cervical Broom Collection Guide

For list of a compatible lubricants and lubricant usage see:

•          ThinPrep Pap Test Lubricant Compatibility List​

•          Lubricant Usage During Pap Collection Letter

​For Appropriate ThinPrep Vial Labeling see:​​

•          ThinPrep Vial Labeling Instructions​

Additional References:

Cervical Broom Collection Guide

Endocervical Brush-Spatula Collection Guide

Lubricant Usage During Pap Collection Letter​

ThinPrep Pap Test Lubricant Compatibility List

ThinPrep Vial Labeling Instructions​​

Reference Range Information
Performing Location Reference Range
Marshfield - Cytopathology​ Interpretative Report (Bethesda System)​
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
88142​ ​ ​ Screening Purposes - ThinPrep Pap​ ​
88141
 ​ ​ Screening Purposes - Interp. By Physician​ ​
88142​ ​ ​ Diagnostic Purposes - ThinPrep Pap​ ​
88141​ ​ ​ Diagnostic Purposes - Interp. By Physician​ ​
87624​ ​ ​ HPV - Nucleic Acid Method​ ​

​87625
​​​HPV Genotyping (16, 18/45) (NAM)
​
Synonyms/Keywords
​​​​Pap and HPV Co-Testing​ + HPV Genotyping Reflex
Ordering Applications
Ordering Application Description
​Cerner ​Pathology GYN Request-Liquid Prep w/HPV+GENO
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​ ThinPrep vial​ ​ 20 mL​ ​
 ​
Collection Processing
Obtain an adequate sampling from the ectocervix using a plastic spatula. Immediately rinse the spatula into the ThinPrep PreservCyt Solution vial by swirling the spatula vigorously in the vial 10 times. Discard the spatula. Obtain an adequate sampling from the endocervix using an endocervical brush device. Insert the brush into the cervix until only the bottom-most fibers are exposed. Slowly rotate 1/4 to 1/2 turn in one direction. DO NOT OVER-ROTATE. Immediately rinse the brush in the PreservCyt Solution by rotating the device in the solution 10 times while pushing against the PreservCyt vial wall. Swirl the brush vigorously to further release material. Discard the brush. Tighten the cap so that the torque line on the cap passes the torque line on the vial.
 
Record the patient name and medical record number on the vial. ​

NOTE: Self-collected pap tests are not FDA approved and will be rejected by the laboratory. 
Specimen Stability Information
Specimen Type Temperature Time
ThinPrep​ Room Temperature​ 4 Weeks​
Rejection Criteria
See:  HUMAN PAPILLOMAVIRUS (HPV) and HPV GENOTYPING
​Frozen specimen
​Self-collected specimen

Interference
Lubricants may increase the risk of contaminating and obscuring the cellular sample. When collecting a specimen, warm water is suggested to lubricate and warm the speculum. If a lubricant must be utilized, a sparing application to the outer portion of the speculum, with avoidance of the tip, is recommended. The following lubricant brands are acceptable to use with the PreServCyt S​olution: Surgilube, CerviLube or Pap Test Lubricating Jelly
Useful For
The cervicovaginal smear is a test for the detection of premalignant, cellular changes, which are precursors to carcinoma of the cervix.  The conventional pap smear, when used as part of a regular screening program has been credited with reducing the incidence of cervical cancer worldwide.  
​
The Thin-Prep pap test has been approved by the U.S. Food and Drug Administration as a replacement for the conventional pap smear and is endorsed by the College of American Pathologists as a method to improve the accuracy of pap examinations.   The Thin Prep pap test improves detection of low-grade and more severe lesions.  By improving detection, disease can be identified at an earlier stage when it is more easily and cost-effectively treated. 
Reference Range Information
Performing Location Reference Range
Marshfield - Cytopathology​ Interpretative Report (Bethesda System)​
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield - Cytopathology​ Monday-Friday​ 3 day​s ThinPrep, Light Microscopy​
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
88142​ ​ ​ Screening Purposes - ThinPrep Pap​ ​
88141
 ​ ​ Screening Purposes - Interp. By Physician​ ​
88142​ ​ ​ Diagnostic Purposes - ThinPrep Pap​ ​
88141​ ​ ​ Diagnostic Purposes - Interp. By Physician​ ​
87624​ ​ ​ HPV - Nucleic Acid Method​ ​

​87625
​​​HPV Genotyping (16, 18/45) (NAM)
​
For most current information refer to the Marshfield Laboratory online reference manual.