HIV-1 Western Blot Oral 

Laboratory Fee Schedule

Procedure: MZZ0231A

CPT: 86689

Synonym(s): HIV-1 Western Blot Oral
Requisition Form G-2A
Test Description Proteins from HIV-1 are separated using gel electrophoresis then trans-blotted to nitrocellulose sheets. Conjugate is added and if specific HIV-1 antibodies are present, they will bind to the HIV-1 proteins.
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 Oral fluid specimens collected with OraSure® HIV-1 Oral Specimen Collection Device
Minimum Volume/Size Required 0.75 mL
Storage/Preservation Prior to Shipping Oral fluid specimens may be stored at 2°C to 37°C for a maximum of 21 days or frozen at -20°C for 6 weeks.
Transport Medium N/A
Specimen Labeling At least 2 patient specific identifiers: First and last name as one identifier and a DOB or a unique patient specific identifier (e.g. Medical Record number); must match information on submission form (G-2A).
Shipping and Specimen Handling Requirements
  • Ship according to Dangerous Goods Regulations, IATA, and/or CFR 49.
  • Handle as infectious agent using universal precautions.
  • Triples contain in accordance with federal shipping regulations for infectious agents.
    Additional forms & resources
Method Protein detection
Turn-around Time N/A
Interferences/Limitations Material must be viable.   Improper storage or shipping temperatures limit organism recovery.
Causes for Rejection Insufficient quantity, unacceptable specimen type or source, improper shipping conditions, expired media or collection container, discrepancies between specimen label and submission form, and/or incomplete or missing submission form.
Additional Information N/A