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Powering better outcomes with comprehensive hepatitis A–E testing

In the US, viral hepatitis cases continue to climb, disproportionately affecting younger patients and underserved communities. Many people are unaware of their infection, making screening even more vital. If left untreated, hepatitis can lead to adverse outcomes, from cirrhosis to liver cancer. We’re powering affordable care through extensive screening options, seamless results reporting, and clinical expertise—all designed to help you and your patients manage hepatitis at every stage.

Powering improved hepatitis management at every stage of your patient’s care

34K

estimated HAV cases, 20201

2M+

Americans are chronically infected with HBV2

4X

increase in HCV cases VS. 10 years ago3

5-10 yrs

for liver cirrhosis/failure to occur in 70%–80% of patients with chronic HBV/HDV infection4

Eliminating viral hepatitis as a public health threat

The Viral Hepatitis National Strategic Plan provides a framework for eliminating viral hepatitis in the US by 2030, focusing on hepatitis A, B, and C.

Hepatitis A:
Experiencing a resurgence

Hepatitis A virus (HAV) typically spreads through contaminated food and water, but in the US is more commonly spread from person to person.

Who’s at increased risk for HAV?1

  • People who are homeless
  • People who use drugs
  • Men who have sex with men
  • People who are incarcerated
  • People with chronic liver disease

Why a resurgence?1

  • Despite a vaccine, dramatic increase in cases since 2016
  • Large person-to-person outbreaks in the US
  • Caused by injected drug use and homelessness

Quest offers the testing needed for diagnosis and assessment of immune response.

Hepatitis B:
Updated screening guidance for adults

Hepatitis B virus (HBV) is a highly prevalent infection that, left untreated, can cause serious health problems. The CDC now recommends that all adults aged 18 years and older in the US be screened at least once in their lifetime.5

Who else should be screened?5

  • Infants born to HBV-infected people
  • All pregnant people during each pregnancy

Periodic risk-based testing recommendations have expanded to include5:

  • People who are currently or have been incarcerated*
  • People with a history of sexually transmitted infections or multiple sex partners*
  • People with hepatitis C*
  • People born in certain countries where HBV is common
  • People born in the US and not vaccinated as infants whose parents were born in countries with high rates of HBV
  • Men who have sex with men
  • People who inject drugs
  • People with HIV infection
  • Household contact and sexual contacts of people with known HBV infection
  • People who are on immunosuppressive therapy
  • People with end-stage renal disease
  • People with elevated liver enzymes

*CDC testing recommendations added 3/10/23

Hepatitis C:
Guidelines recommend universal screening

Detecting hepatitis C virus (HCV) infection early can help decrease its impact on patients. Together with today’s effective drug therapies, universal screening can help eradicate HCV.

Who should be screened for HCV?6,7

  • All adults 18 years and older, at least once*
  • People with conditions or exposures
  • People with ongoing risk factors
  • Pregnant women* and any person who requests screening

*Except in settings where the prevalence of HCV infection is less than 0.1%

Quest offers the full complement of guideline-based HCV testing, as well as reflex options to perform all testing from just one sample.

Hepatitis D:
The importance of screening

Hepatitis D virus (HDV) only occurs in people already infected with HBV, so the HBV vaccine can help prevent HDV. Symptoms can be severe, so early detection is critical.

What are the 2 types of HDV infection?

  • Coinfection: HBV + HDV at the same time
  • Superinfection: HDV develops after HBV infection

Who’s at increased risk for HDV?4

  • People chronically infected with HBV
  • Infants born to mothers infected with HDV
  • Sex partners of persons infected with HDV
  • Men who have sex with men
  • People who inject drugs
  • Household contacts of people with HDV infection
  • Healthcare and public safety workers
  • Hemodialysis patients

Quest’s comprehensive testing can help you diagnose and monitor HDV infection before, during, and after treatment.

Hepatitis E:
Remains very rare

In the US, cases of hepatitis E virus (HEV) are rare, largely affecting men over age 40.8 Most patients fully recover from acute infection.

Who can HEV be serious for?8

  • Pregnant women
  • People with chronic liver disease
  • Organ-transplant recipients

Quest offers the HEV antibody (IgG, IgM) testing needed for diagnosis.

Rely on comprehensive viral hepatitis testing from Quest.

Powering viral hepatitis diagnosis and management

Quest can help you ensure the best outcomes for your patients, with services including:

  • Seamless results reporting with fast turnaround times
  • Quanum® Lab Services Manager, which saves time managing testing and billing
  • Our dedicated team of MDs, PhDs, and science liaisons available for consultations
  • Patient education resources to support adherence
  • Access to test results for patients via MyQuest™
  • Our nationwide network of 2,250 Patient Service Centers

Manage every stage with comprehensive hepatitis testing

We’re dedicated to providing you with the insights you need to manage hepatitis at every stage and ensure the best treatment outcomes for your patients.

Test Name

Clinical Application

Test Code

CPT Code(s)

Hepatitis Panel, Acute with Reflex to Confirmation includes Hepatitis A IgM Antibody (512); Hepatitis B Surface Antigen with Reflex Confirmation (498); Hepatitis B Core Antibody IgM (4848); Hepatitis C Antibody with Reflex to HCV, RNA, Quantitative, Real-Time PCR (8472)

Screens for acute hepatitis caused by hepatitis A, B, or C viruses.

10306(X)a,b

80074

Hepatitis Panel, General includes Hepatitis A Antibody, Total (508); Hepatitis B Surface Antibody, Qualitative (499); Hepatitis B Surface Antigen with Reflex Confirmation (498); Hepatitis B Core Antibody, Total (501); Hepatitis C Antibody with Reflex to HCV, RNA, Quantitative, Real-Time PCR (8472)

Detects hepatitis caused by hepatitis A, B, or C viruses.

6462(X)a,b

86704, 86706, 86708, 86803, 87340

Components of panels can be ordered separately.

The CPT codes provided are based on American Medical Association guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

Powering better hepatitis management.

Learn more about our comprehensive A–E testing.

References

  1. Centers for Disease Control and Prevention. Widespread person-to-person outbreaks of hepatitis A across the United States. Last reviewed June 28, 2021. Accessed July 28, 2021. View here.
  2. Hepatitis B Foundation. Hepatitis B facts and figures. Accessed July 28, 2021. View here.
  3. Hofmeister MG, Rosenthal EM, Barker LK, et al. Estimating prevalence of hepatitis C virus infection in the United States, 2013–2016. Hepatology. 2019;69:1020-31.
  4. Centers for Disease Control and Prevention. Hepatitis D questions and answers for health professionals. Last reviewed March 9, 2020. Accessed July 28, 2021. View here.
  5. CDC. Hepatitis B questions and answers for the public. Accessed March 20, 2023. View here.
  6. US Preventive Services Task Force. Screening for hepatitis C virus infection in adolescents and adults: US Preventive Services Task Force recommendation statement. JAMA. 2020;323(10):970-975.
  7. Centers for Disease Control and Prevention. CDC recommendations for hepatitis C screening among adults—United States, 2020. April 10, 2020. Accessed July 28, 2021. View here.
  8. Centers for Disease Control and Prevention. Hepatitis E questions and answers for health professionals. Last reviewed September 15, 2020. Accessed July 28, 2021. View here.

Test Name

Clinical Application

Test Code

CPT Code(s)

Hepatitis A Antibody (IgM)

First-line diagnostic test for acute HAV infection.

512(X)

86709

Hepatitis A Antibody, Total

Screens for evidence of an immune response to HAV.

508(X)

86708

Hepatitis A Antibody, Total with Reflex to IgM

Indicates prior or acute infection with, or immunization to, HAV.

36504(X)a,b

86708

The CPT codes provided are based on American Medical Association guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

Test Name

Clinical Application

Test Code

CPT Code(s)

Hepatitis B Surface Antigen with Reflex Confirmation

First-line test for current HBV infection. Indicates chronic HBV infection when still positive 6 months after initial diagnosis.

498

87340

Hepatitis B Core Antibody, Total, with Reflex to IgM

Indicates prior, current, or acute infection with HBV.

37676

86704

Hepatitis B Surface Antibody Immunity, Quantitative

Indicates whether a person has immunity to HBV.

8475

86317

Hepatitis B Surface Antigen, Quantitative, Monitoring

Used on persons previously diagnosed with HBV infection. Confirms ongoing HBV replication and monitors response to antiviral therapy.

94333(X)

83520

Hepatitis B Virus DNA, Quantitative, Real-Time PCR

Determines need to treat chronic HBV infection. Indicates chronic HBV infection when still positive 6 months after diagnosis. Monitors response to therapy. Demonstrates viral replication in patients with mutant HBV (eg, HBeAg- and HBeAb+ individuals). Predicts likelihood of response to therapy.

8369(X)c

87517

Hepatitis Be Antibody

Appears in the early convalescence of HBV infection.

556(X)

86707

Hepatitis Be Antigen

Indicates active viral replication and high infectivity. Assesses likelihood of chronic hepatitis and HBV carriage.

555(X)

87350

Hepatitis Be Panel Includes Hepatitis Be Antigen (555); Hepatitis Be Antibody (556)

Indicates likelihood of chronic infection. Indicates response to therapy and level of infectivity (disappearance of HBeAg and appearance of HBeAb).

27(X)a

86707, 87350

HBV Screen with Reflexes Includes Hepatitis B Surface Antigen with Reflex Confirmation (498); Hepatitis B Core Antibody, Total, with Reflex to IgM (37676); Hepatitis B Surface Antibody Immunity, Quantitative (8475)

Indicates current and/or past HBV infection. Detects the presence of antibodies to find immunity after HBV infection or vaccination.

39170

Components of panels can be ordered separately.

The CPT codes provided are based on American Medical Association guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

Test Name

Clinical Application

Test Code

CPT Code(s)

Hepatitis C Antibody with Reflex to HCV, RNA, Quantitative, Real-Time PCR

Diagnoses HCV infection. Establishes baseline viral load for treatment monitoring.

8472(X)b

86803

Hepatitis C Antibody with Reflex to HCV Virus RNA, Quantitative, Real-Time PCR with Reflex to Genotype, LiPA®

Detects HCV antibody and confirms active HCV infection. Establishes baseline viral load for treatment monitoring. Identifies HCV genotype to guide treatment selection and duration of treatment.

94345(X)

86803

Hepatitis C Antibody and HIV-1/2, Screen and Diagnostic Panel with Reflexes

Diagnoses HCV and HIV infection. Differentiates between HIV-1 and HIV-2. Establishes baseline HCV viral load and HCV genotype to guide treatment approach.

36646(X)

86803, 87389

Hepatitis C-Infected Patient, Baseline Panel 1 Includes Hepatic Function Panel (10256); CBC (Includes Differential and Platelets) (6399); Creatinine (375); Hepatitis A Antibody, Total (508); Hepatitis B Surface Antibody, Qualitative (499); Hepatitis B Surface Antigen with Reflex Confirmation (498); Hepatitis B Core Antibody, Total (501); Hepatitis C Viral RNA, Genotype, LiPA (37811); HIV-1/2 Antigen and Antibodies, Fourth Generation, with Reflexes (91431)

Assesses risk from underlying medical conditions and comorbid infections prior to initiation of HCV therapy. Establishes baseline laboratory parameters to define changes during therapy. Determines HCV genotype to guide treatment selection and duration of therapy. Hepatitis B Surface Antigen: Positive samples will be confirmed based on the manufacturer’s FDA-approved recommendations at an additional charge (CPT code: 87341).
If HIV Antigen and Antibody, Fourth Generation Screen is repeatedly reactive, then HIV-1/2 Antibody Differentiation will be performed at an additional charge (CPT codes: 86701, 86702).
If HIV-1/2 Antibody Differentiation is indeterminate or negative, then HIV-1 RNA, Qualitative, TMA will be performed at an additional charge (CPT code: 87535).

91704(X)a,c

80076, 85025, 82565, 86708, 87340, 86704, 87389, 87902, 86706

Hepatic Function Panel Includes Total Protein (754[X]), Albumin (223[X]), Globulin (calculated), Albumin Globulin Ratio (calculated), Total Bilirubin (287[X]), Direct Bilirubin (285[X]), Indirect Bilirubin (calculated), Alkaline Phosphatase (234[X]), AST (822[X]), ALT (823[X])

Assesses risk from underlying medical conditions and comorbid infections prior to, during, and after treatment of HDV.

10256(X)

80076

Hepatitis C Viral RNA, Quantitative, Real-Time PCR

Confirms active HCV infection and establishes baseline viral load. Assesses prognosis (prior to the initiation of therapy). Monitors response to therapy. Tests for recurrence or reinfection. Linear range: 15–100,000,000 IU/mL. LOD: 10–13 IU/mL.

35645(X)

87522

Liver Fibrosis, FibroTest-ActiTest Panel

Assists with noninvasive evaluation of liver fibrosis in patients with HCV infection.

92688(X)g

81596

Components of panels can be ordered separately.

The CPT codes provided are based on American Medical Association guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

Test Name

Clinical Application

Test Code

CPT Code(s)

Hepatitis D Virus (HDV) Antibody, Total

Diagnoses HDV infection in patients with fulminant hepatic failure or known previous HBV infection.

4990(X)d

86692

Hepatitis D Virus (HDV) IgM Antibody, EIA

Detects HDV infection in patients with fulminant hepatic failure or known previous HBV infection, including those with reactive HDV total antibody results and suggestive clinical features but negative HDV RNA results.

35664(X)

86692

Hepatitis D Virus RNA, Qualitative, Real-Time PCR

Confirms HDV infection in individuals with reactive HDV antibody results. Diagnoses HDV infection in symptomatic, HBsAg-positive, HDV antibody-negative individuals with suggestive clinical features. Tests for resolution.

34469(X)d

87798

Hepatic Function Panel Includes Total Protein (754[X]), Albumin (223[X]), Globulin (calculated), Albumin Globulin Ratio (calculated), Total Bilirubin (287[X]), Direct Bilirubin (285[X]), Indirect Bilirubin (calculated), Alkaline Phosphatase (234[X]), AST (822[X]), ALT (823[X])

Assesses risk from underlying medical conditions and comorbid infections prior to, during, and after treatment of HDV.

10256(X)

80076

Components of panels can be ordered separately.

The CPT codes provided are based on American Medical Association guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

Test Name

Clinical Application

Test Code

CPT Code(s)

Hepatitis E Virus (HEV) Antibody (IgG)

Confirms an immune response to HEV.

36583(X)

86790

Hepatitis E Virus (HEV) Antibody (IgM)

Confirms an acute/recent HEV infection.

36582(X)

86790

Hepatitis E Virus (HEV) Antibodies (IgG/IgM)

Confirms an acute/recent/prior HEV infection.

15085(X)

86790(x2)

The CPT codes provided are based on American Medical Association guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.