Laboratory Fee Schedule
Procedure: MBD0201A
CPT: 86709
	| Synonym(s): | 
	HAV IgM, HAVAb IgM, Type A Hepatitis, Infectious Hepatitis, Epidemic Hepatitis, Epidemic Jaundice, and Catarrhal Jaundice | 
	| Requisition Form | 
	G-2A | 
	| Test Description | 
	Enzyme Immunoassay (EIA) for the qualitative detection of IgM Antibodies to hepatitis A virus in human serum  | 
	| Pre-Approval Needed | 
	N/A | 
	| Supplemental Information Required | 
	N/A | 
	| Supplemental Form(s) | 
	N/A | 
	| Performed on Specimens from (sources) | 
	Human | 
	| Sample/Specimen Type for Testing | 
	Serum | 
	| Minimum Volume/Size Required | 
	500 µL | 
	| Storage/Preservation Prior to Shipping | 
	
	
	- Store serum at 2°C to 8°C for up to 48 hours.
 
	- For storage longer than 48 hours, store at -20°C or below until tested. 
 
	 
	 | 
	| Transport Medium | 
	N/A | 
	| Specimen Labeling | 
	
	
	- Two patient-specific identifiers required on specimen (e.g., patient full name, date of birth, medical record number)
 
	- Three patient identifiers are preferred.
 
	- Patient identifiers on specimen label must exactly match identifiers on submission form (e.g., abbreviated name on label and full name on form is not acceptable). 
 
	- Additional DSHS Laboratory specimen labeling guidelines available online here. 
 
	 
	 | 
	| Shipping and Specimen Handling Requirements | 
	
	
	- Ship according to Dangerous Goods Regulations, IATA, and/or CFR 49.
 
	- Category B Biological Substance, UN3373 shipping requirements apply.  
 
	- Handle as infectious agent using universal precautions.  
 
	- Triple-contain in accordance with federal shipping regulations for infectious agents.  
 
	- Submitters are responsible for packaging and shipping specimens according to regulatory requirements.  
 
	- If specimens will arrive at the lab within 48 hours of collection, refrigerate at 2°C–8°C and ship overnight on cold packs.
 
	- If specimens will arrive at the lab more than 48 hours after time of collection, freeze at -20°C or colder, and ship overnight on dry ice.
 
	- Additional DSHS Laboratory specimen shipping guidelines online here.  
 
	 
	 | 
	| Method | 
	EIA for the detection of antibodies | 
	| Turn-around Time | 
	4 working days | 
	| Interferences/Limitations | 
	Gross hemolysis, lipemia, bacterial contamination, and heterophilic antibodies may cause interference in the assay. | 
	| Common Causes for Rejection | 
	
	
	- Insufficient specimen quantity.
 
	- Unacceptable specimen type or source.
 
	- Improper shipping conditions.
 
	- Expired media or collection container.
 
	- Expired reagents/media/collection container. 
 
	- Discrepancies between G-2A submission form and specimen label. 
 
	- Missing/incomplete/illegible submission form or label.
 
	 
	 | 
	| Additional Information | 
	 A non-reactive result does not exclude the possibility of infection with hepatitis A virus. |