Women’s Health Test Reference Guide At Quest Diagnostics, we help ensure that you provide the best possible care to your patients.

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Use this guide to quickly find tests and services that meet every diagnostic need, from wellness to prenatal to symptom-specific diagnoses.

Multiple test codes are available. Refer to the Test Center at QuestDiagnostics.com/TestCenter for test information. Table of Contents

General Health 3 Cancer Risk Assessment 3 Hereditary Breast Cancer 3 Hereditary Colon Cancer 3 Cancer Screening 4 Cervical Cancer (with ThinPrep® Collection System) 14 Cervical Cancer (with SurePath™ Collection System) 14 Cervical Cancer (Age-based Test Codes) 14 Colon Cancer 4 Vaginal Cancer 4 Cancer Monitoring/Tumor Markers 4 Cardiovascular Disease 4 Endocrine-related Disorders 4 Diabetes 4 Gonadal Function 5 Mineral and Bone 5 Thyroid Dysfunction 6 Gastrointestinal Diseases 6 Hemostasis and Thrombosis 6 Menorrhagia 6 Thrombophilia 6 Histopathology 6 Infectious Diseases 7 Culture and Stains 7 Genitourinary Infections 7 Hepatitis 7 HIV 7 Influenza 8 Sexually Transmitted Infections 8 Preconception and 9 Carrier Screening 9 Infertility 9 Recurrent Miscarriage 9 Pregnancy Diagnosis 10 Maternal Serum Screening 10 Noninvasive Prenatal Screening 10 Prenatal Diagnosis 10 Pregnancy Complications and Monitoring 11 Infectious Diseases of Concern During Pregnancy 11 Prescription Drug Monitoring 12 Individual Tests 12 Panels 12 Test Code Test Name Test Code Test Name General Health 294 Urea Nitrogen (BUN) 823 Alanine Aminotransferase (ALT) 905 Uric Acid 223 Albumin 7909 Urinalysis with Reflex to Microscopic 234 5463 Urinalysis, Complete Includes macroscopic and microscopic examination. 243 6448 Urinalysis, Macroscopic 822 Aspartate Aminotransferase (AST) 927 Vitamin B12 (Cobalamin) 10165 Includes BUN/ ratio (calculated), calcium, carbon 937 White Blood Cell Count dioxide, chloride, creatinine with estimated GFR, glucose, potassium, sodium, and urea nitrogen (BUN). Cancer Risk Assessment 285 , Direct Hereditary Breast Cancer 303 Calcium 92587 BRCAvantage Plus™1 Includes detection of point mutations, deletions, and 310 Carbon Dioxide duplications in the BRCA1, BRCA2, TP53, PTEN, CDH1, STK11, and PALB2 genes. 6399 CBC (Includes Differential and ) Includes WBC, RBC, hemoglobin, hematocrit, MCV, MCH, 92573 BRCAvantage® with Reflex to Breast Plus MCHC, RDW, count, MPV, and differential (absolute Panel1 and percent neutrophils, lymphocytes, monocytes, Includes detection of point mutations, deletions, and eosinophils, and basophils). duplications in the BRCA1 and BRCA2 genes with reflex to point mutations, deletions, and duplications in the TP53, 330 Chloride PTEN, CDH1, STK11, and PALB2 genes. 10231 Comprehensive Metabolic Panel 92140 BRCAvantage®, Ashkenazi Jewish Screen w/ Includes albumin, albumin/globulin ratio (calculated), alkaline 1 phosphatase, ALT, AST, BUN/creatinine ratio (calculated), Reflex BRCAvantage, Comprehensive calcium, carbon dioxide, chloride, creatinine with estimated Includes test code 91864; test code 91863 added with GFR, globulin (calculated), glucose, potassium, sodium, total additional charge and CPT code when none of the 3 founder bilirubin, total protein, and urea nitrogen. mutations are detected. 4420 C-Reactive Protein (CRP) 91864 BRCAvantage®, Ashkenazi Jewish Screen1 Includes detection of the 3 HBOC syndrome founder 375 Creatinine mutations (c.68_69delAG [185delAG, 187delAG], c.5266dupC Includes estimated glomerular filtration rate (eGFR). [5382insC, 5385insC], and c.5946delT [6174delT]). 8459 Creatinine, Random Urine 91863 BRCAvantage®, Comprehensive1 Includes detection of point mutations, deletions, and 34392 Panel duplications in the BRCA1 and BRCA2 genes. Includes carbon dioxide, chloride, potassium, and sodium. 91866 BRCAvantage®, Rearrangement1 457 Includes detection of deletions and duplications in the BRCA1 and BRCA2 genes. 466 Folate, Serum 91865 BRCAvantage®, Single Site1 482 Gamma-Glutamyltransferase (GGT) Includes detection of a familial mutation in the BRCA1 or 483 Glucose BRCA2 gene. 509 Hematocrit 92586 Breast Plus Panel without BRCA1 Includes detection of point mutations, deletions, and 510 Hemoglobin duplications in the TP53, PTEN, CDH1, STK11, PALB2 genes. 35489 Hemoglobinopathy Evaluation 92568 CDH1 Sequencing and Deletion/Duplication1 Includes hemoglobin A, A2, F, and any variants (eg, C, E, S), RBC count, hemoglobin, hematocrit, MCV, MCH, and RDW. 92571 PALB2 Sequencing and Deletion/Duplication1 10256 Hepatic Function Panel 92566 1 Includes alkaline phosphatase; ALT; AST; albumin; globulin PTEN Sequencing and Deletion/Duplication (calculated); albumin/globulin ratio (calculated); total, direct, 92565 1 and indirect (calculated) bilirubin; and total protein. STK11 Sequencing and Deletion/Duplication 1 571 Iron, Total 92560 TP53 Sequencing and Deletion/Duplication 7573 Iron, Total and Total Iron Binding Capacity Hereditary Colon Cancer 593 (LD) 91461 Lynch Syndrome Panel1 Includes mutation testing of MLH1, MSH2, MSH6, PMS2, and 606 3’-EPCAM deletion. 622 Magnesium 91584 Lynch Syndrome, MLH1 Familial Deletion/ Duplication1 718 Phosphate (as Phosphorus) 91460 Lynch Syndrome, MLH1 Sequencing and 723 Platelet Count Deletion/Duplication1 733 Potassium 91459 Lynch Syndrome, MSH2 Familial Deletion/ 1 783 Red Blood Cell Count Duplication (Including EPCAM) 836 Sodium 91471 Lynch Syndrome, MSH2 Sequencing and Deletion/Duplication (Including EPCAM)1 287 Total Bilirubin 91458 Lynch Syndrome, MSH6 Sequencing and 754 Total Protein Deletion/Duplication1 3 Test Code Test Name Test Code Test Name 91463 Lynch Syndrome, PMS2 Familial Deletion/ 92145 Cardio IQ® Advanced Lipid Panel Duplication1 Includes total, HDL, and LDL (calculated) ; ; cholesterol/HDL ratio (calculated); non-HDL 91457 Lynch Syndrome, PMS2 Sequencing and (calculated); apolipoprotein B; lipoprotein(a); ion mobility Deletion/Duplication1 lipoprotein fractionation; reflex to direct LDL; and Cardio IQ interpretive report. 14984(X) MLH1 Mutation, One Exon, HNPCC1 92527 Cardio IQ® Advanced Lipid Panel and 14981(X) MSH2 Mutation, One Exon, HNPCC1 Inflammation Panel Same as 92145 plus highly-sensitive CRP abd Lp-PLA2. 91230 MSH6 Gene Deletion or Duplication1 91726 Cardio IQ® Apolipoprotein B 14983(X) MSH6 Mutation, One Exon, HNPCC1 92052 Cardio IQ® ASCVD Risk Panel with Score Cancer Screening Same as 92053 plus Cardio IQ interpretive report. Cervical Cancer (See page 14) 91717 Cardio IQ® Cholesterol, Total Colon Cancer 91723 Cardio IQ® Direct LDL 16983 ColoVantage® (Methylated Septin 9)1 91743 Cardio IQ® Fibrinogen Antigen, Nephelometry 11293 Fecal Globin by Immunochemistry (InSure®), 91719 Cardio IQ® HDL Cholesterol Medicare Screen 91733 Cardio IQ® Homocysteine 11290 Fecal Globin by Immunochemistry (InSure®) 91737 Cardio IQ® hs-CRP 4947(X) Hemoquant, Stool 91716 Cardio IQ® Lipid Panel Vaginal Cancer Same as 7600 plus Cardio IQ report. 93102 HPV Genotypes 16, 18/45, Post-Hysterectomy, 92061 Cardio IQ® Lipid Panel with Reflex to Direct LDL Vaginal Same as 91716 plus reflext to direct LDL when is >400 mg/dL. 93101 HPV mRNA E6/E7, Post-Hysterectomy, Vaginal 91729 ® 93136 HPV mRNA E6/E7, Post-Hysterectomy, Vaginal Cardio IQ Lipoprotein (a) with Reflex to HPV 16, 18/45 91604 Cardio IQ® Lipoprotein Fractionation, Ion Mobility Cancer Monitoring/Tumor Markers Includes LDL particle number, LDL small and medium 237 Alpha-Fetoprotein, Tumor Marker quantification, LDL pattern, LDL peak size, HDL large quantification, and Cardio IQ interpretive report. 29256 CA 125 91738 Cardio IQ® Lp-PLA2 (PLAC®) 17717 CA 125 with HAMA Treatment 91734 Cardio IQ® Omega 3 and 6 Fatty Acids, Plasma 5819(X) CA 15-3 91718 Cardio IQ® Triglycerides 4698 CA 19-9, Serum 334 Cholesterol, Total 29493 CA 27.29 8293 Direct LDL 15018 CEA with HAMA Treatment 37801 Fibrinogen Antigen, Nephelometry 978 CEA, Serum 608 HDL Cholesterol 8396 hCG, Total, Quantitative 31789 Homocysteine 19720 hCG, Total, with HAMA Treatment 10124 hs-CRP 16500 HE4, Ovarian Cancer Monitoring 7600 Lipid Panel 34445 Inhibin B1 Includes total cholesterol, triglycerides, HDL cholesterol, calculated LDL cholesterol, cholesterol/HDL ratio, and non- 593 Lactate Dehydrogenase (LD) HDL cholesterol. 91155 ROMA® (Risk of Ovarian Malignancy Algorithm) 14852(X) Lipid Panel with Reflex to Direct LDL Includes human epididymis protein 4 (HE4), CA 125, Same as 7600 plus direct LDL if triglyceride is >400 mg/dL. menopausal status, and numerical score. 34604 Lipoprotein (a) 267 Thyroglobulin 14530 Lp-PLA2 (Lipoprotein-Associated 90814 Thyroid Cancer Monitoring1 Phospholipase A2) Includes thyroglobulin with reflex to either second generation (Beckman Coulter) thyroglobulin or LC/MS/MS 91001 Omega-3 and -6 Fatty Acids, Plasma thyroglobuin. 896 Triglycerides Cardiovascular Disease Endocrine-related Disorders 5224 Apolipoprotein B Diabetes 92053 ASCVD Risk Panel with Score Includes total, HDL, and LDL (calculated) cholesterol; 92027 Diabetes Risk Panel with Score triglycerides; cholesterol/HDL ratio (calculated); non- Includes glucose; hemoglobin A1c; total, HDL, and LDL HDL (calculated); 10-year and lifetime atherosclerotic (calculated) cholesterol; triglycerides; cholesterol/HDL ratio cardiovascular risk scores (calculated); and reflex to direct (calculated); non-HDL (calculated); 8-year risk of developing LDL. diabetes (calculated); and reflex to direct LDL.

4 Test Code Test Name Test Code Test Name 91920 Diabetes Risk Panel without Score 19720 hCG, Total, with HAMA Treatment Same as 92027 except 8-year risk of developing diabetes is not calculated and reported. 36707(X) Hirsutism Panel 2 Includes androstenedione, DHEA sulfate, and free and total 91712(X) Diabetes, Newly Diagnosed and Monitoring testosterone. Panel Includes glucose; hemoglobin A1c; total, HDL, and LDL 8352 17-Hydroxypregnenolone, LC/MS/MS (calculated) cholesterol; triglycerides; cholesterol/HDL ratio (calculated); non-HDL (calculated); alkaline phosphatase; ALT; 17180 17-Hydroxyprogesterone, LC/MS/MS AST; albumin; globulin (calculated); albumin/globulin ratio (calculated); total, direct, and indirect (calculated) bilirubin; 11303 Hyperglycosylated hCG (h-hCG) total protein; urinary microalbumin; and creatinine (urine and 1 serum). 90581 Hyperglycosylated hCG (h-hCG), Sensitive 8340 Fructosamine 34472 Inhibin A 483(X) Glucose 15201(X) 17-Ketosteroids with Creatinine, 24-Hour Urine 35181 Glucose Tolerance Test, 2 Specimens (75g) 34445 Inhibin B1 Includes fasting and 2-hour specimens. 615 LH 23475 Glucose Tolerance Test, 3 Specimens (75g) Includes fasting, 1-hour, and 2-hour specimens. 10328 Ovarian Antibody Screen with Reflex to Titer, IFA 18927 Glucose Tolerance Test, Gestational, 3 31493(X) Pregnenolone, LC/MS/MS Specimens (75g) 17183 Progesterone, LC/MS/MS Includes fasting, 1-hour, and 2-hour specimens; ADA- supported 1-step GDM evaluation. 746 Prolactin 6745 Glucose Tolerance Test, Gestational, 4 40049 Prolactin, Dilution Study Specimens (100g) Includes fasting and 1-, 2-, and 3-hour specimens; ACOG- and 16122 Prolactin, Total and Monomeric ADA-supported 2nd step of 2-step GDM evaluation. 30740 Sex Hormone Binding Globulin 8477 Glucose, Gestational Screen (50g), 135 Cutoff Based on specimen collected 1 hour post 50 g glucose; ACOG- 90426 Steroid Panel, PCOS/CAH Differentiation1 supported 1st step of 2-step GDM evaluation. (Panel components may be ordered separately.) Includes 11-deoxycortisol (30543), 17-hydroxyprogesterone 19833 Glucose, Gestational Screen (50g), 140 Cutoff (17180), androstenedione (17182), DHEA (19894), and total Based on specimen collected 1 hour post 50 g glucose; ACOG- and free testosterone (36170). and ADA-supported 1st step of 2-step GDM evaluation. 496 Hemoglobin A1c 90424 Steroid Panel, Polycystic Ovary Syndrome (PCOS) 16715 Hemoglobin A1c with Reflex to GlycoMark® Includes androstenedione, DHEA, and total and free testosterone. 561 Insulin 90433 Steroid Panel, Premature Adrenarche 6517 Microalbumin, Random Urine (with Creatinine) Includes 17-hydroxypregnenolone, 17-hydroxyprogesterone, androstenedione, DHEA, and total testosterone. Gonadal Function 36170 Testosterone, Free and Total, LC/MS/MS 8658(X) 1 Alpha Subunit 14966 Testosterone, Free, Bioavailable and Total, 92208 3α-Androstanediol Glucuronide, ELISA2 LC/MS/MS 17182 Androstenedione, LC/MS/MS 15983 Testosterone, Total, LC/MS/MS 16842(X) Anti-Mullerian Hormone AssessR™1 Mineral and Bone Metabolism 19894 DHEA (Dehydroepiandrosterone), 29498 Alkaline Phosphatase, Bone Specific Unconjugated, LC/MS/MS 303 Calcium 402 DHEA Sulfate 306 Calcium, Ionized 90567 Dihydrotestosterone, LC/MS/MS1 1633(X) Calcium, Random Urine with Creatinine 36168 Dihydrotestosterone, Free, Serum1 36421 Collagen Cross-Linked N-Telopeptide (NTx), 24-Hour Urine 36169 Estradiol, Free, LC/MS/MS Includes estradiol and free estradiol. 36167(X) Collagen Cross-Linked N-Telopeptide (NTx), 30289 Estradiol, Ultrasensitive, LC/MS/MS Urine 34883(X) Estriol, LC/MS/MS, Serum 17406 Collagen Type I C-Telopeptide (CTx) 439 Estrogen, Total, Serum 16322 Osteocalcin, N-MID 36742 Estrogens, Fractionated, LC/MS/MS 16609 Procollagen Type I Intact N Terminal Propeptide Includes estrone, ultrasensitive estradiol, and estriol. 36578 PTH Antibody1 37104(X) Estrone Sulfate 36736 PTH, Intact (ICMA) and Ionized Calcium 23244 Estrone, LC/MS/MS 8837 PTH, Intact and Calcium 470 FSH (Follicle Stimulating Hormone) 34478(Z) PTH-Related Protein (PTH-RP)2 7137 FSH and LH 92888 QuestAssureD™ 25-Hydroxyvitamin D (D2, D3), 8396 hCG, Total, Quantitative LC/MS/MS

5 Test Code Test Name Test Code Test Name 17306 Vitamin D, 25-Hydroxy, Total, Immunoassay 8847 with INR Thyroid Dysfunction 4459(X) Ristocetin Cofactor 34429 T3, Free (FT3) [Non-Dialysis] 36585 36598 T3, Free, Tracer Dialysis 5168 von Willebrand Antigen, Multimeric Analysis 859 T3, Total 70068 von Willebrand Disease (vWD) Type 2N (vWF: Factor VIII Binding Activity) 866 T4, Free (FT4) 4919 von Willebrand Factor Antigen 35167 T4, Free, Direct Dialysis3 10924(X) von Willebrand Factor Collagen Binding Assay2 17733 T4, Total (Thyroxine) Thrombophilia 267 Thyroglobulin Antibodies 22 Activated Protein C-Resistance 30278 Thyroglobulin Panel Includes thyroglobulin and thyroglobulin antibody. 216 Antithrombin III Activity 90814 Thyroid Cancer Monitoring 30340(X) Beta2-Glycoprotein I Antibodies (IgG, IgA, IgM) Includes thyroglobulin antibody with reflex to either second (Panel components may be ordered separately.) generation (Beckman Coulter) thyroglobulin (16206) or Includes IgG (36554), IgA (36552), and IgM (36553). LC/MS/MS thyroglobuin (90810). 7352 Cardiolipin Antibodies (IgG, IgA, IgM) (Panel 15102(X) Thyroid Cascading Reflex components may be ordered separately.) Includes a TSH. If TSH is elevated, reflexes to free T4 and TPO Includes IgG (4662), IgA (4661), and IgM (4663). antibody. If TSH is decreased, reflexes to free T4 and possibly free T3. Not for use in pregnant women. 15780(X) dRVVT Screen with Reflex to dRVVT Confirm 5081 Thyroid Peroxidase Antibodies and dRVVT 1:1 Mix 3 899 TSH 17900 (Leiden) Mutation Analysis Polymerase chain reaction, oligonucleotide ligation assay, 19537 TSH with HAMA Treatment fluorescent microspheres. 90896 TSH, Pregnancy 31789 Homocysteine Gastrointestinal Diseases 10062 Phosphatidylserine Antibodies (IgG, IgA, IgM) 19955 Celiac Disease Comprehensive Panel 36595 Phosphatidylserine Antibodies (IgG, IgM) Includes tissue transglutaminase antibody (IgA) with reflex to endomysial antibody screen (IgA) and reflex to 10163(X) Phosphatidylserine Antibody (IgA) endomysial antibody titer; and serum IgA with reflex to tissue transglutaminase antibody (IgG). 1777 Protein C Activity 15064 Endomysial Antibody Screen (IgA) with Reflex 10170 Protein S Antigen, Free to Titer 17909 Prothrombin (Factor II) 20210G>A Mutation 3 539 IgA, Serum Analysis 8821 Tissue Transglutaminase Antibody (IgA) 17408 PTT-LA with Reflex to Hexagonal Phase Confirmation 11070 Tissue Transglutaminase Antibody (IgG) 19676(X) Recurrent Miscarriage Evaluation/ Hemostasis and Thrombosis Panel3 Includes antithrombin III activity, beta2-glycoprotein antibody Menorrhagia (IgG, IgA, IgM), cardiolipin antibody (IgG, IgA, IgM), dRVVT (See also tests listed under General Health, Endocrine-related Disorders, and screen with reflexes to dRVVT confirm and 1:1 mix, factor V Genitourinary Infections.) (Leiden) mutation, homocysteine, phosphatidylserine antibody (IgG, IgM), protein C activity, free protein S, prothrombin (factor 331 Factor II Activity, Clotting II) 20210G>A mutation analysis, and PTT-LA with reflex to hexagonal phase confirmation. 344 Factor V Activity, Clotting 19671(X) Recurrent Miscarriage Evaluation/Coagulation 347 Factor VIII Activity, Clotting Panel with Consultation3 Same as 19676(X) plus coagulation consultation. 359(X) Activity, Clotting Histopathology 360 Factor XI Activity, Clotting (See also Cancer Screening—Cervical) 37801 Fibrinogen Antigen, Nephelometry 10676 Cytology, Non-Gynecological, Fluid, Washings, 19651 Menorrhagia Screen with Consultation Brushings, or FNA Includes aPTT, factors VIII and XI activity, prothrombin time Includes sample preparation and microscopic interpretation with INR, ristocetin cofactor activity, vWF antigen, and by a pathologist; additional stains (at additional charge) may coagulation consultation. be done at the discretion of the pathologist. 19649(X) Menorrhagia Screen without Consultation 14516 Tissue, Gynecological Pathology Report Same as 19651 minus the coagulation consultation. Includes sample preparation and microscopic interpretation by a pathologist; additional stains (at additional charge) may 8922(X) Mixing Study be done at the discretion of the pathologist. Includes prothrombin time with reflex to prothrombin time mix, PTT-LA with reflex to immediate PTT-LA mix and 3542 Tissue, Pathology Report incubated PTT-LA mix (if indicated). Includes sample preparation and microscopic interpretation by a pathologist; additional stains (at additional charge) may 763 Partial Thromboplastin Time, Activated (aPPT) be done at the discretion of the pathologist.

6 Test Code Test Name Test Code Test Name Infectious Diseases 15509 SureSwab®, Bacterial Vaginosis/Vaginitis1 Includes Atopobium vaginae, Gardnerella vaginalis, Culture and Stains Lactobacillus sp, Megasphaera sp., Trichomonas vaginalis, C albicans, C glabrata, C parapsilosis, and C tropicalis. 4550 Culture, Aerobic Bacteria 16495 SureSwab®, Candida albicans DNA1 18881 Culture, Aerobic Bacteria with Gram Stain 90388 ® 1 4469 Culture, Anaerobic Bacteria with Gram Stain SureSwab , Candida krusei DNA ® 1 389 Culture, Blood 16494 SureSwab , Candidiasis, PCR Includes C albicans, C glabrata, C parapsilosis, and C tropicalis. 4477 Culture, Ear, External 91475 SureSwab®, Mycoplasma genitalium, PCR1 4480 Culture, Eye 91474 SureSwab®, Mycoplasma hominis, PCR1 4553 Culture, Fungus, Other than Hair, Skin, Blood, with Fluorescent KOH 91477 SureSwab®, Mycoplasma/Ureaplasma Panel, PCR1 39515 Culture, Fungus, Skin, Hair or Nails 19550 SureSwab®, Trichomonas vaginalis RNA, 4605 Culture, Fungus, Skin, Hair, Nail with Direct Qualitative TMA Fluorescent/KOH 91476 ® 1 4558 Culture, Genital SureSwab , Ureaplasma Species, PCR ® 1 4556 Culture, Sputum/Lower Respiratory 17333 SureSwab , Vaginosis/Vaginitis Plus Includes Atopobium vaginae, Candida albicans, C glabrata, C 394 Culture, Throat parapsilosis, C tropicalis, Chlamydia trachomatis, Gardnerella vaginalis, Lactobacillus sp, N gonorrhoeae, Megasphaera sp, 395 Culture, Urine, Routine and T vaginalis. 689 Culture, Viral, Body Fluids, Tissues 16491 SureSwab®, Vaginosis, CT/NG1 Includes Atopobium vaginae, C trachomatis, Gardnerella 3968 Culture, Yeast with Direct Fluorescent KOH vaginalis, Lactobacillus sp, Megasphaera sp, and N gonorrhoeae. 20541 Culture, Yeast, with Identification 90801 Trichomonas vaginalis RNA, Qualitative TMA, 8631 Escherichia coli O157 Culture Males 8627 Fungal Stain 90521 Trichomonas vaginalis RNA, Qualitative TMA, 14824 Fungal Stain, Calcofluor, Skin, Hair or Nails Pap Vial 497 Gram Stain 39507 Yeast Identification 681 Ova and Parasites, Stool, Concentrate and 92187 Yeast Identification and Susceptibility Permanent Smear Hepatitis 10108 Salmonella/Shigella/Campylobacter Culture 508 Hepatitis A Antibody, Total and Shiga Toxin with Reflex to E coli O157 Culture 512 Hepatitis A IgM Components can be ordered individually: Campylobacter culture (4475), Salmonella and Shigella culture (10019), and 4848 Hepatitis B Core Antibody (IgM) Shiga toxin with reflex to E coli O157 culture (30264). 501 Hepatitis B Core Antibody, Total 4485 Streptococcus Group A Culture 499 Hepatitis B Surface Antibody, Qualitative 5617 Streptococcus Group B Culture Includes bacterial broth-enhanced culture and aerobic 498 Hepatitis B Surface Antigen with Reflex to bacteria isolation and identification. Confirmation Genitourinary Infections 8472(X) Hepatitis C Antibody with Reflex to HCV RNA, (See also Sexually Transmitted Infections) Quantitative Real-Time PCR 14577 Bacterial Vaginosis/Vaginitis Panel 10306 Hepatitis Panel, Acute with Reflex to Includes Candida species, Gardnerella vaginalis, and Confirmation Trichomonas vaginalis; BD Affirm™ VPIII identification system Includes HAV IgM, HBV surface antigen with reflex to used. confirmation, HBV core antibody (IgM), and HCV antibody. 34336(X) Candida Antigen Detection 6462 Hepatitis Panel, General Includes total HAV antibody, HBV surface antibody, HBV 90487 Candida DNA, Qualitative Real-Time PCR, surface antigen with reflex to confirmation, total HBV core Serum1 antibody, and HCV antibody. 4554 Mycobacteria, Culture, with Fluorochrome HIV Smear 91431 HIV-1/2 Antigen and Antibodies, Fourth 387 Mycobacterium Identification Generation, with Reflexes Methods used include DNA probe, biochemicals, and Includes HIV-1/2 antigen and antibody with reflex to chromatography. HIV-1/2 antibody differentiation; if differentiation test is indeterminant or negative, reflex to HIV-1 RNA. Guideline 10526 Mycobacterium, Culture, Blood recommended for detection of HIV infection. 16898 SureSwab®, Bacterial Vaginosis DNA, 91432 HIV-1/2 Antibody Differentiation (supplemental Quantitative Real-Time PCR1 use only) Includes Atopobium vaginae, Gardnerella vaginalis, Lactobacillus sp, and Megasphaera sp. 16185 HIV-1 RNA, Qualitative TMA 34977 HIV-2 DNA/RNA, Qualitative Real-Time PCR1

7 Test Code Test Name Test Code Test Name Influenza 91431 HIV-1/2 Antigen and Antibodies, Fourth Generation, with Reflexes 35945 Influenza A and B Culture, Rapid Method Includes HIV-1/2 antigen and antibody with reflex to HIV-1/2 antibody differentiation; if differentiation test is 16807 Influenza A H1N1 (2009) Real-Time RT-PCR indeterminant or negative, reflex to HIV-1 RNA. Guideline 16251 Influenza A Virus H1/H3 Subtyping, Real-Time recommended. RT-PCR1 91432 HIV-1/2 Antibody Differentiation 16861 Influenza A/B RT-PCR with Reflex to Influenza A 16185 HIV-1 RNA, Qualitative TMA H1N1 (2009) RT-PCR1 34977 HIV-2 DNA/RNA, Qualitative Real-Time PCR1 16086 Influenza Type A and B RNA, Qualitative Real- time RT-PCR1 17171 HSV-2 IgG Inhibition, ELISA 8357 Influenza Virus Type A and B Antigen Detection, 34177(X) HTLV I/II DNA, Qualitative Real-Time PCR1 DFA 36175 HTLV-I/II Antibody w/Reflex to Confirmation Sexually Transmitted Infections Assay 14577 Bacterial Vaginosis/Vaginitis Panel 8511 HTLV-I/II, Confirmatory Assay2 Includes Candida species, Gardnerella vaginalis, and Trichomonas vaginalis; BD Affirm™ VPIII identification system 19553(X) Lymphogranuloma Venereum (LGV) used. Differentiation Antibody Panel, MIF3 Includes C trachomatis (L2) IgG, IgA, and IgM; C trachomatis 4966 Chlamydia trachomatis Antigen, DFA (D-K) IgG, IgA, and IgM; C pneumoniae IgG, IgA, and IgM; C psittaci IgG, IgA, and IgM; and interpretation. 690 Chlamydia trachomatis Culture 871 Mycoplasma hominis/Ureaplasma Culture 11361 Chlamydia trachomatis RNA, TMA 480 Neisseria gonorrhoeae (GC) Culture 16505 Chlamydia trachomatis RNA, TMA, Rectal 11362(X) Neisseria gonorrhoeae RNA, TMA 15031 Chlamydia trachomatis,TMA (Alternate Target) 16504 Neisseria gonorrhoeae RNA, TMA, Rectal 11363 Chlamydia trachomatis/Neisseria gonorrhoeae RNA, TMA 15033 Neisseria gonorrhoeae TMA (Alternate Target) 16506 Chlamydia trachomatis/Neisseria gonorrhoeae 36126 RPR (Diagnosis) with Reflex to Titer and RNA, TMA, Rectal Confirmatory Testing 91448 Chlamydia/N. gonorrhoeae and T. vaginalis RNA, 799 RPR (Monitor) with Reflex to Titer Qualitative TMA, Pap Vial 90570 SureSwab®, Herpes Simplex Virus, Type 1 and 2 91773 Chlamydia/Neisseria gonorrhoeae RNA, TMA DNA, Real-Time PCR1 with Reflex to Alternate Target 19550 SureSwab®, Trichomonas vaginalis RNA, 91436 Chlamydia/NG, Qualitative TMA and HSV 1/2 Qualitative TMA DNA, Real-Time PCR, Pap Vial 17333 SureSwab®, Vaginosis/Vaginitis Plus1 91437 Chlamydia/NG, T. vaginalis, QL TMA and HSV 1/2 Includes Atopobium vaginae, Candida albicans, C glabrata, C DNA, Real-Time PCR, Pap Vial parapsilosis, C tropicalis, Chlamydia trachomatis, Gardnerella vaginalis, Lactobacillus sp, N gonorrhoeae, Megasphaera sp., 38481 Chlamydophila pneumonia Antibody (IgM)3 and T vaginalis. 37346 Chlamydophila psittaci Antibodies (IgG, IgA, 15509 SureSwab®, Bacterial Vaginosis/Vaginitis1 IgM)3 Includes Atopobium vaginae, Gardnerella vaginalis, Lactobacillus sp, Megasphaera sp., Trichomonas vaginalis, 4112 FTA-ABS (Fluorescent Treponemal Antibody- C albicans, C glabrata, C parapsilosis, and C tropicalis. Absorption) 16492 SureSwab®, CT/NG, T vaginalis 3636 Herpes Simplex Virus 1 IgG, Type-Specific ® 1 Antibody (HerpeSelect®) 91475 SureSwab , Mycoplasma genitalium, PCR 6447 Herpes Simplex Virus 1/2 (IgG), Type-Specific 91474 SureSwab®, Mycoplasma hominis, PCR1 Antibodies (HerpeSelect®) 91477 SureSwab®, Mycoplasma/Ureaplasma Panel, 17169 Herpes Simplex Virus 1/2 IgG, HerpeSelect® PCR1 with Reflex to HSV-2 Inhibition 91476 SureSwab®, Ureaplasma Species, PCR1 17170(X) Herpes Simplex Virus 2 IgG, HerpeSelect® with 16491 SureSwab®, Vaginosis, CT/NG1 Reflex to HSV-2 Inhibition Includes Atopobium vaginae, C trachomatis, Gardnerella vaginalis, Lactobacillus sp, Megasphaera sp, and 3640 Herpes Simplex Virus 2 IgG, Type-Specific N gonorrhoeae. Antibody (HerpeSelect®) 90349 Syphilis Antibody Cascading Reflex 34290 Herpes Simplex Virus Antigen Detection, DFA The cascade begins with Treponema pallidum antibody using an immunoassay; a T pallidum equivocal or positive 2692 Herpes Simplex Virus Culture result reflexes to RPR; a reactive RPR reflexes to RPR titer; a nonreactive RPR reflexes to T pallidum antibody using particle 2649 Herpes Simplex Virus Culture with Reflex to agglutination. Typing 653 Treponema pallidum Antibody, Particle 19502 Herpes Simplex Virus, Type 1 and 2 DNA, Agglutination Quantitative Real-Time PCR3 90569 Herpes Simplex Virus, Type 1/2 DNA, Real-Time PCR, Pap Vial1 8 Test Code Test Name Test Code Test Name 16595(X) Treponema pallidum DNA, Qualitative Real-Time 11176(X) Medium Chain Acyl-CoA Dehydrogenase PCR1 (MCAD) Mutation Analysis1 90801 Trichomonas vaginalis RNA, Qualitative TMA, 90899 Mucolipidosis Type IV Mutation Analysis1 Males 90893 Niemann-Pick Disease Mutation Analysis1 90521 Trichomonas vaginalis RNA, Qualitative TMA, Pap Vial 16152(X) Phenylketonuria (PKU) Mutation Analysis1 30509 VDRL, Serum 90949 Prenatal Carrier Screen (CF, Fragile X, SMA)1 Preconception and Pregnancy 18041 SMA Carrier Screen1 Carrier Screening 90903 Tay-Sachs Disease Mutation Analysis1 1 Includes HEXA gene analysis for 1278insTATC, delta7.6kb, 11175 Alpha-Globin Common Mutation Analysis G269S, IVS9+1G>A, IVS12+1G>C, and R178H mutations and Consider ordering the Hemoglobinopathy Evaluation test (test the R247W pseudodeficiency allele. Consider hexosaminidase code 35489[X]) before this test. enzyme carrier screening before or concurrently with this test. 1 90994 Ashkenazi Jewish Panel (4 Tests) 16313 XSense®, Fragile X with Reflex1 Includes mutations associated with Canavan disease, cystic Includes a reflex to Southern blot when PCR result is either fibrosis, familial dysautonomia, and Tay-Sachs disease. not normal or gray zone. 90891 Ashkenazi Jewish Panel (11 Tests)1 Infertility Includes mutations associated with Bloom syndrome, Canavan disease, cystic fibrosis, Gaucher disease, glycogen 15053(X) CFTR Intron 8 Poly-T Analysis1 storage disease, familial dysautonomia, Fanconi anemia, MSUD Jewish mutation, mucolipodosis type IV, Niemann-Pick 14596 Chromosome Analysis, Blood disease, and Tay-Sachs disease. 14595(X) Chromosome Analysis, High Resolution 14974 Beta-Globin Complete1 Consider ordering the Hemoglobinopathy Evaluation test (test 14606(X) FISH, SRY/X Centromere3 code 35489[X]) before this test. 90581 Hyperglycosylated hCG (h-hCG), Sensitive1 90872 Bloom Syndrome DNA Mutation Analysis1 34445 Inhibin B1 90905 Canavan Disease Mutation Analysis1 10328 Ovarian Antibody Screen with Reflex to Titer, IFA 92068 ® 1 CFvantage Cystic Fibrosis Expanded Screen 3 Includes analysis for >150 mutations. 19492(X) Sperm Antibody (IgA, IgG) 10917(X) Cystic Fibrosis Complete Rare Mutation 14679 Y Chromosome Microdeletion, DNA Analysis2 Analysis, Entire Gene Sequence1 Recurrent Miscarriage 16080(X) Cystic Fibrosis Gene Deletion or Duplication3 22 Activated Protein C-Resistance 10913(X) Cystic Fibrosis Rare Mutation Analysis, One Exon3 249 ANA IFA Screen with Reflex to Titer and Pattern, IFA 10915(X) Cystic Fibrosis Rare Mutation Analysis, Two Exon3 90072 ANA, IFA with Reflex to Titer/Pattern// SLE Antibodies 10458 Cystic Fibrosis Screen Includes ANA screen (IFA) with reflexes to titer and pattern, Includes analysis for 32 mutations. dsDNA antibody, Sm antibody, and chromatin (nucleosomal) antibody. 90912 1 Familial Dysautonomia Mutation Analysis 14890(X) Antiphospholipid Antibody Panel 16141(X) Familial Mediterranean Fever Mutation Includes beta2-glycoprotein I antibodies (IgG, IgA, IgM), 1 phosphatidylserine antibodies (IgG, IgA, IgM), and cardiolipin Analysis antibodies (IgG, IgA, IgM). 1 90897 Fanconi Anemia DNA Mutation Analysis 19872(X) Antiphospholipid Syndrome Diagnostic Panel 1 Includes cardiolipin antibody (IgG, IgA, IgM), beta2- 90907 Gaucher Disease, DNA Mutation Analysis glycoprotein I antibody (IgG, IgA, IgM), lupus testing: PTT-LA with reflex to hexagonal phase confirmation, 90915 Glycogen Storage Disease Type Ia Mutation and dRVVT screen with reflexes to dRVVT confirm and dRVVT 1 Analysis (Ashkenazi Jewish) 1:1 mix. 90828 Hemophilia A (Factor VIII) Inversions1 216 Antithrombin III Activity 16612 HEXA Mutation Analysis, Gene Sequencing1 30340(X) Beta2-Glycoprotein I Antibodies (IgG, IgA, IgM) Includes sequencing of the entire coding region, the intron- (Panel components may be ordered separately.) exon splice sites, and the promoter region of the HEXA gene. Includes IgG (36554), IgA (36552), and IgM (36553). Common mutation testing (Tay-Sachs Disease Mutation Analysis) must be performed prior to, or concurrently with, 7352 Cardiolipin Antibodies (IgG, IgA, IgM) (Panel this test. Hexosaminidase enzyme carrier screening should components may be ordered separately.) also be considered before or concurrently with this test. Includes IgG (4662), IgA (4661), and IgM (4663). 10247(X) Huntington Disease Mutation Analysis1 90929 Chromosomal Microarray, POC, ClariSure® 90909 Maple Syrup Urine Disease (MSUD) Mutation Oligo-SNP Analysis (Ashkenazi Jewish)1 14596 Chromosome Analysis, Blood 91284 Medium Chain Acyl-CoA Dehydrogenase 14595(X) Chromosome Analysis, High Resolution (MCAD) Gene Sequencing

9 Test Code Test Name Test Code Test Name 15780(X) dRVVT Screen with Reflex to dRVVT Confirm 16020 First Trimester Screen, Hyperglycosylated hCG and dRVVT 1:1 Mix (h-hCG)1 Includes PAPP-A, h-hCG, NT, Down syndrome risk, and 17900 Factor V (Leiden) Mutation Analysis3 interpretation. Polymerase chain reaction, oligonucleotide ligation assay, fluorescent microspheres. 16148 Integrated Screen, Part 11 Includes PAPP-A and NT. 31789 Homocysteine 16150 Integrated Screen, Part 21 37491 Lupus (SLE) Panel (Panel components may be Includes AFP; hCG; uE3; inhibin A; PAPP-A and NT from part 1; ordered separately.) NTD, Down syndrome, and trisomy 18 risk; and interpretation. Includes ANA with reflex to titer and pattern (249); C4 (353) and C3 (351) complement components; rheumatoid factor 5059 Maternal Serum AFP (4418); TPO (16336), SS-A (38568), SS-B (38569), Sm (37923), Includes AFP, neural tube defect risk, and interpretation. Sm/RNP (38567), Scl-70 (4942), ribosomal P (34283), actin (IgG) (15043), and gastric parietal cell antibodies (15114); and 15934 Penta Screen reticulin IgA (37520), mitochondrial (259), dsDNA (Crithidia) Includes AFP; hCG; uE3; inhibin A; h-hCG; NTD, Down (37092), striated muscle (266), and myocardial antibody (261) syndrome, and trisomy 18 risk; and interpretation. screens with reflex to titers. 30294 Quad Screen 10062 Phosphatidylserine Antibodies (IgG, IgA, IgM) Includes AFP; hCG; uE3; inhibin A; NTD, Down syndrome, and trisomy 18 risk; and interpretation. 36595 Phosphatidylserine Antibodies (IgG, IgM) 16131 Sequential Integrated Screen, Part 11 10163(X) Phosphatidylserine Antibody (IgA) Includes PAPP-A; hCG; NT; Down syndrome and trisomy 18 risk; and interpretation. 1777 Protein C Activity 16133 Sequential Integrated Screen, Part 21 10170 Protein S Antigen, Free Includes AFP; hCG; uE3; inhibin A; PAPP-A and NT from part 1; 17909 Prothrombin (Factor II) 20210G>A Mutation NTD, Down syndrome, and trisomy 18 risk; and interpretation. Analysis3 16165 Serum Integrated Screen, Part 11 Includes PAPP-A. 17408 PTT-LA with Reflex to Hexagonal Phase Confirmation 16167 Serum Integrated Screen, Part 21 Includes AFP; hCG; uE3; inhibin A; PAPP-A from part 1; NTD, 19671(X) Recurrent Miscarriage Evaluation/Coagulation Down syndrome, and trisomy 18 risk; and interpretation. Panel with Consultation3 Includes antithrombin III activity, beta2-glycoprotein antibody Noninvasive Prenatal Screening (IgG, IgA, IgM), cardiolipin antibody (IgG, IgA, IgM), dRVVT screen with reflexes to dRVVT confirm and 1:1 mix, factor V 92777 QNatal™ Advanced1 (Leiden) mutation, homocysteine, phosphatidylserine antibody Includes prenatal risk assessment for trisomies, sex (IgG, IgM), protein C activity, free protein S, prothrombin chromosome aneuploidies, and microdeletions: trisomies (factor II) 20210G>A mutation analysis, PTT-LA with reflex to 21, 18, and 13; 45,X (Turner), XXX (triple X), XXY (Klinefelter), hexagonal phase confirmation, and coagulation consultation. and XYY; and 22q (DiGeorge syndrome), 1p (1p36 deletion syndrome), 15q (Angelman/Prader-Willi syndromes), 5p 19676(X) Recurrent Miscarriage Evaluation/Coagulation (Cri-du-chat syndrome), 4p (Wolf-Hirschhorn syndrome), 11q Panel3 (Jacobsen syndrome), and 8q (Langer-Giedion syndrome). Includes antithrombin III activity, beta2-glycoprotein antibody (IgG, IgA, IgM), cardiolipin antibody (IgG, IgA, IgM), dRVVT Prenatal Diagnosis screen with reflexes to dRVVT confirm and 1:1 mix, factor V (Leiden) mutation, homocysteine, phosphatidylserine antibody 4929(X) Acetylcholinesterase (IgG, IgM), protein C activity, free protein S, prothrombin (factor 1 II) 20210G>A mutation analysis, and PTT-LA with reflex to 16061(X) Achondroplasia Mutation Analysis hexagonal phase confirmation. 91615 Alpha-Fetoprotein and Acetylcholinesterase, 19881(X) Systemic Lupus Erythematosus (SLE) Amniotic Fluid with Reflex to HbF Comprehensive Diagnostic Panel Includes ANA screen (IFA) with reflex to titer and pattern; 232(Z) Alpha-Fetoprotein, Amniotic Fluid with Reflex chromatin (nucleosomal), DNA (ds), RNP, Sm, and Sjögren’s to AchE and Fetal Hgb (SS-A and SS-B) antibodies; complement component C3c and C4c; and total complement (CH50). 91711 Alpha-Globin Common Mutation Analysis, Fetus1 Pregnancy Diagnosis 16124(X) Alpha-Globin Gene Deletion or Duplication1 8435 hCG, Total, Qualitative [Serum] 16116(X) Alpha-Globin Gene Sequencing 396 hCG, Total, Qualitative, Urine 90872 1 8396 hCG, Total, Quantitative Bloom Syndrome DNA Mutation Analysis 19720 hCG, Total, with HAMA Treatment 91680 CAH (21-Hydroxylase Deficiency) Common Mutations, Fetal Cells1 19485 hCG with Gestational Table 90905 Canavan Disease Mutation Analysis1 11303 Hyperglycosylated hCG (h-hCG) 90929 Chromosomal Microarray, POC, ClariSure® 90581 Hyperglycosylated hCG (h-hCG), Sensitive1 Oligo-SNP Maternal Serum Screening 90927 Chromosomal Microarray, Prenatal, ClariSure® Oligo-SNP 16145 First Trimester Screen, hCG1 Includes PAPP-A, hCG, NT, Down syndrome risk, and 14591(Z) Chromosome Analysis and AFP with Reflex to interpretation. AchE, Fetal Hgb, Amniotic Fluid 14592(X) Chromosome Analysis, Chorionic Villus Sample

10 Test Code Test Name Test Code Test Name 14590(X) Chromosomes Analysis, Amniotic Fluid Pregnancy Complications and Monitoring 10913(X) Cystic Fibrosis Rare Mutation Analysis, One 7788 ABO and Rh Exon3 Includes ABO blood type (785) and Rh type (792). 10915(X) Cystic Fibrosis Rare Mutation Analysis, 5149 Antibody Identification, Titer and Typing, RBC 3 Two Exon 795 Antibody Screen, RBC with Reflex to 90912 Familial Dysautonomia Mutation Analysis1 Identification, Titer, and Antigen Typing 16141(X) Familial Mediterranean Fever Mutation 19546(X) Bile Acids, Fractionated and Total, Pregnancy 1 Analysis 90929 Chromosomal Microarray, POC, ClariSure® 90897 Fanconi Anemia DNA Mutation Analysis1 Oligo-SNP 36208 Fetal Hemoglobin, Amniotic Fluid 11173 Cyclic Citrullinated Peptide (CCP) Antibody (IgG) 14610(X) FISH, DiGeorge, Velocardiofacial (VCFS)3 38226 Fetal Fibronectin 483(X) Glucose 14605(X) FISH, Prader Willi3 6745 Glucose Tolerance Test, Gestational, 4 14604(X) FISH, Prenatal Screen Includes enumeration of chromosomes 13, 18, 21, X, and Y. Specimens (100g) 14609(X) FISH, Williams3 496 Hemoglobin A1c 3 10256 Hepatic Function Panel 14613(X) FISH, Wolf-Hirschhorn Includes alkaline phosphatase; ALT; AST; albumin; globulin (calculated); albumin/globulin ratio (calculated); total, direct, 14607(X) FISH, X-Linked Ichthyosis Steroid Sulfatase and indirect (calculated) bilirubin; and total protein. Deficiency3 35057 L/S Ratio, Phosphatidylglycerol (PG) 16300 Fragile X DNA Analysis, Fetus1 19971 Lecithin/Sphingomyelin Ratio with Qualitative 90907 Gaucher Disease, DNA Mutation Analysis1 Phosphatidyl G 90915 Glycogen Storage Disease Type Ia Mutation 20210 Obstetric Panel Analysis (Ashkenazi Jewish)1 Includes an ABO blood type and Rh type, CBC with differential and platelet count, HBV surface antigen with a reflex to 90828 Hemophilia A (Factor VIII) Inversions1 confirmation, RBC antibody screen with a reflex to ID and titer, RPR with a reflex to titer and confirmation, and rubella IgG 16612 HEXA Mutation Analysis, Gene Sequencing1 antibody. Includes sequencing of the entire coding region, the intron- exon splice sites, and the promoter region of the HEXA gene. 1683 Phosphatidylglycerol, Qualitative, Amniotic Consider common mutation testing (Tay-Sachs Disease Fluid Mutation Analysis) prior to, or concurrently with, this test. 3 Hexosaminidase enzyme carrier screening should also be 91740 Platelet Antibody, Direct (IgG) considered before or concurrently with this test. 8626 Red Blood Cell Antigen Typing 10247(X) Huntington Disease Mutation Analysis1 11291 Rh, Weak D (DU) 90909 Maple Syrup Disease (MSUD) Mutation Analysis (Ashkenazi Jewish)1 17669 Rheumatoid Arthritis Diagnostic Panel (Panel components may be ordered separately.) 10262 Maternal Cell Contamination Study, STR Includes rheumatoid factor (4418) and cyclic citrullinated Analysis2 peptide antibody (IgG) (11173). 91472 Rheumatoid Arthritis Diagnostic Panel, 11176(X) Medium Chain Acyl-CoA Dehydrogenase ™ 3 (MCAD) Mutation Analysis1 IdentRA with 14-3-3 eta (Panel components may be ordered separately.) 36587(X) MEN2 and FMTC Mutations, Exons 10, 11, Includes rheumatoid factor (4418) and cyclic citrullinated 13-161 peptide antibody (IgG) (11173) and 14-3-3eta protein (91455). 3 90899 Mucolipidosis Type IV Mutation Analysis1 35167 T4, Free, Direct Dialysis 90893 Niemann-Pick Disease Mutation Analysis1 899 TSH 90896 TSH, Pregnancy 16152(X) Phenylketonuria (PKU) Mutation Analysis1 Infectious Diseases of Concern During Pregnancy 90949 Prenatal Carrier Screen (CF, Fragile X, SMA)1 6732 Cytomegalovirus Antibodies (IgG, IgM) 16053(X) Resistance to Thyroid Hormone (RTH) Mutation Analysis1 403 Cytomegalovirus Antibody (IgG) 15088(X) Rett Syndrome Mutation Analysis1 8503 Cytomegalovirus Antibody (IgM) 26382(X) Sickle Cell Anemia, DNA Probe Analysis, Fetus1 10600(X) Cytomegalovirus DNA, Quantitative Real-Time PCR3 18041 SMA Carrier Screen1 19583(X) Cytomegalovirus IgG Avidity, ELISA 16869 1 SMA Diagnostic Test 4848 Hepatitis B Core Antibody (IgM) 1 90903 Tay-Sachs Disease Mutation Analysis 498 Hepatitis B Surface Antigen with Reflex to Includes HEXA gene analysis for 1278insTATC, delta7.6kb, G269S, IVS9+1G>A, IVS12+1G>C, and R178H mutations and Confirmation the R247W pseudodeficiency allele. Consider hexosaminidase enzyme carrier screening before or concurrently with this test. 18852 HSV and VZV, Direct Immunofluorescence

11 Test Code Test Name Test Code Test Name 6447 Herpes Simplex Virus 1/2 (IgG), Type-Specific 92222 S Amphetamines, Urine Antibodies (HerpeSelect®) 70245 S,C 70209 Q 91431 HIV-1/2 Antigen and Antibodies, Fourth Generation, with Reflexes 92223 S Barbiturates, Urine Includes HIV-1/2 antigen and antibody with reflex to 70246 S,C HIV-1/2 antibody differentiation; if differentiation test is 70230 Q indeterminant or negative, reflex to HIV-1 RNA. Guideline recommended. 92224 S Benzodiazepines, Urine 91432 HIV-1/2 Antibody Differentiation 70247 S,C 70231 Q 16185 HIV-1 RNA, Qualitative TMA 16207 S Buprenorphine, Urine 34977 HIV-2 DNA/RNA, Qualitative Real-Time PCR1 70249 S,C 18998 Q 34329(X) Listeria Antibody, CF (Serum) 3 93093 S,C Buprenorphine, including Naloxone, Urine 36565 Mumps Virus Antibody (IgM) 93094 Q 1 70172(X) Mumps Virus RNA, Qualitative Real-Time PCR 18999 Q Carisoprodol Metabolite, Urine 8946 Parvovirus B19 Antibodies (IgG, IgM) 92225 S Cocaine Metabolite, Urine 8945(X) Parvovirus B19 Antibody (IgG) 70248 S,C 90082 Q 8948 Parvovirus B19 Antibody (IgM) 18996 Q Fentanyl, Urine 34296(X) Parvovirus B19 DNA, Qualitative Real-Time PCR3 91251 Q Eszopiclone, Urine 19724(X) Parvovirus B19 DNA, Quantitative Real-Time 70205 Q Gabapentin, Urine 3 PCR 92226 S Heroin Metabolite, Urine 36126 RPR (Diagnosis) with Reflex to Titer and 90081 S,C Confirmatory Testing 90333 Q 799 RPR (Monitor) with Reflex to Titer 92227 S Marijuana Metabolite, Urine 18989 S,C 37673 Rubella Antibodies (IgG, IgM) Diagnostic 70233 Q 4422(X) Rubella Antibody (IgM) 92228 S MDMA/MDA, Urine 90078 S,C 802 Rubella Immune Status 90334 Q 16730(X) 1 Rubella Virus RNA, Qualitative Real-Time PCR 70206 Q Meperidine, Urine 5617 Streptococcus Group B Culture 92229 S Methadone Metabolite, Urine 91768 Streptococcus Group B DNA, PCR with Broth 18990 S,C Enrichment 70234 Q 91770 Streptococcus Group B DNA, PCR with Broth 90247 Methylphenidate, Urine Enrichment and Reflex to Susceptibility 92230 S Opiates, Urine 16491 SureSwab®, Vaginosis, CT/NG1 18991 S,C Includes Atopobium vaginae, C trachomatis, Gardnerella 70237 Q vaginalis, Lactobacillus sp, Megasphaera sp, and N gonorrhoeae. 92231 S Oxycodone, Urine 18992 S,C 90349 Syphilis Antibody Cascading Reflex 70238 Q Includes T pallidum antibody (EIA) with reflex to RPR screen (if EIA equivocal or positive) and subsequent reflex to titer (if RPR 92232 S Phencyclidine Urine screen positive) or T pallidum antibody (particle agglutination) 18993 S,C (if RPR screen nonreactive). 90083 Q 3679 Toxoplasma Antibody (IgG) 70208 Q Pregabalin Urine 37207 Toxoplasma Antibody (IgM) 90244 Q Tapentadol, Urine 34052(X) Varicella Zoster Virus (VZV) DNA, Qualitative Real-Time PCR1 70207 Q Tramadol, Urine 4439 Varicella Zoster Virus Antibody (IgG) 70204 Q Tricyclic Antidepressants, Urine 8683 Varicella Zoster Virus Antibody (IgM) 91258 Q Zolpidem, Urine 2691 Varicella Zoster Virus, Rapid Method, Culture Panels (Panel components may be ordered separately. Additional panels are 30509 VDRL, Serum available. B, blood; U, urine; S, serum.) Prescription Drug Monitoring 91358 B Drug Test, General Toxicology 91359 U Includes LC/MS/MS analysis for >100 drugs or drug Individual Tests (S, screen; C, confirmation; Q, quantitative) 91360 S metabolites from various drug classes such as analgesics, anticonvulsants, antidepressants, antipsychotics, anxiolytics, 90079 S,C Alcohol Metabolites, Urine illicit drugs, muscle relaxants, opioids, sedatives, and 92142 Q stimulants. A complete list of compounds can be found at http://education.QuestDiagnostics.com/faq/FAQ101.

12 Test Code Test Name Test Code Test Name 16260 S Pain Management Base Profile, Urine 90347 S Pain Management Profile 5, Urine 16259 S,C Includes creatinine, oxidant, pH, specific gravity, and 90348 S,C Includes creatinine, oxidant, pH, specific gravity and immunoassay screen for benzodiazepines, cocaine immunoassay screen for amphetamines, barbiturates, metabolite, opiates and oxycodone. Positive results reflex to benzodiazepines, cocaine metabolite, marijuana metabolite, mass spectrometry quantitation if ordered.. methadone metabolite, opiates, and oxycodone. Positive results reflex to mass spectrometry quantitation if ordered. 92466 S Pain Management Profile 1, Urine 92450 S,C Includes creatinine, oxidant, pH, specific gravity, and 92456 S,C Pain Management Profile 6 with Confirmation, immunoassay screen for amphetamines, barbiturates, Urine benzodiazepines, cocaine metabolite, marijuana Includes creatinine, oxidant, pH, specific gravity and metabolite, methadone metabolite, opiates, oxycodone, and immunoassay screen for alcohol metabolites, amphetamines, phencyclidine. Positive results reflex to mass spectrometry barbiturates, benzodiazepines, cocaine metabolite, heroin quantitation if ordered. metabolite, marijuana metabolite, methadone metabolite, opiates, oxycodone, and phencyclidine. Positives will reflex to mass spectrometry quantitation if ordered.

1 This test was developed and its performance characteristics have been determined by Quest Diagnostics. Performance characteristics refer to the analytical performance of the test. 2 This test was performed using a kit that has not been cleared or approved by the FDA. The analytical performance characteristics of this test have been determined by Quest Diagnostics. This test should not be used for diagnosis without confirmation by other medically established means. 3 This test was developed and its performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. The FDA has determined that such clearance or approval is not necessary. Performance characteristics refer to the analytical performance of the test. Reflex tests are performed at an additional charge and are associated with an additional CPT code. Real-time polymerase chain reaction (PCR) is performed pursuant to a license agreement with Roche Molecular Systems, Inc. Multiple test codes are available. Refer to the Test Center at QuestDiagnostics.com/TestCenter for test information.

13 Cervical Cancer Screening

Test Code Test Name Test Code Test Name 3526 Cytology, Conventional Pap Smear, 1 Slide Cervical Cancer (Age-based Test Codes)2 Individual Tests (with ThinPrep® Collection System) 91384 Image-Guided Pap with Age-Based Screening Protocol3 35455 ThinPrep® [Non Imaging] Pap Includes image-guided Pap (ThinPrep® or SurePath™); if patient is 21–25 years of age, also includes 1) a reflex to 58315 ThinPrep® Imaging System Pap HPV mRNA if Pap is ASCUS and 2) C trachomatis and N gonorrhoeae RNA; if patient is 26–29 years of age, also 90887 HPV mRNA E6/E7 includes a reflex to HPV mRNA if Pap is ASCUS; if patient is 30–65 years of age, also includes HPV mRNA with a reflex 91826 HPV Genotypes 16, 18/45 to HPV genotype 16, 18/45 when Pap is normal and HPV is positive. 90942 HPV mRNA E6/E7 with Reflex to Genotypes 16,18/45 91385 Image-Guided Pap with Age-Based Screening Protocol Plus CT/NG3 Individual Tests (with SurePath™ Collection System) Same as 91384 except C trachomatis and N gonorrhoeae RNA is performed for all age groups. 14471 SurePath™ [Non Imaging] Pap 91386 Image-Guided Pap with Age-Based Screening 18810 SurePath™ Imaging Pap Protocol Plus CT/NG/Trich3 Same as test code 91384 except C trachomatis, ™ 92203 HPV mRNA E6/E7, SurePath Vial1 N gonorrhoeae, and T vaginalis RNA is performed for all age groups. 92392 HPV Genotypes 16,18/45, SurePath™ Vial1 92211 HPV mRNA E6/E7, SurePath™ with Reflex to HPV Genotype 16, 18/451 1 This test was developed and its performance characteristics have been determined by Quest Diagnostics. Performance characteristics refer to the analytical performance of the test. 2 The age-based offerings described above are based on ACOG recommendations and include image-guided Pap tests. The ACOG recommendations do not specify a particular type of Pap test. Both imaged and non-imaged Pap tests are acceptable under the recommendations. Non-imaged Pap tests, as well as the additional testing recommended by ACOG, are available at Quest Diagnostics and may be ordered individually.

3 The analytical performance characteristics of this assay, when used to test SurePath™ specimens, have been determined by Quest Diagnostics.

Reflex and Co-testing Options for Pap and HPV (Based on ACOG Guidelines) ThinPrep® ThinPrep® SurePath™ SurePath™ (Non Imaging) (Imaging) (Non Imaging) (Imaging) Option 1 Ages Pap 35455 58315 14471 18810 Cytology every 21–65 3 years Pap (reflexes to HPV if ASCUS) 90932 90934 14499 18811 Pap (reflexes to HPV if ASCUS) 91913 91912 17258 18817 and CT/NG1 Pap (reflexes to HPV if ASCUS), 91908 91911 — — CT/NG, and T vaginalis1 Option 2 Ages Pap 35455 58315 14471 18810 (preferred): 21–29 Pap (reflexes to HPV if ASCUS) 90932 90934 14499 18811 Cytology every 3 years for Pap (reflexes to HPV if ASCUS) 91913 91912 17258 18817 women 21–29; and CT/NG co-testing (Pap and HPV Pap (reflexes to HPV if ASCUS), 91908 91911 — — combined) for CT/NG, and T vaginalis women 30–65 Ages Pap and HPV 90931 90933 15095 18813 30-65 Pap, HPV, CT/NG 91274 91339 16770 18828 Pap, HPV, CT/NG, T vaginalis 91915 91906 — — Pap and HPV (reflexes to genotype 91411 91414 16306 18829 16,18/45 when Pap–/HPV+)

Pap, HPV (reflexes to genotype 16,18/45 92010 92012 — — when Pap–/HPV+), and CT/NG CT/NG, C trachomatis/N gonorrhoeae RNA. 1 For patients with risk factors for sexually transmitted infections.

14 QuestDiagnostics.com Quest, Quest Diagnostics, any associated logos, and all associated Quest Diagnostics registered or unregistered trademarks are the property of Quest Diagnostics. All third-party marks—® and ™—are the property of their respective owners. © 2016 Quest Diagnostics Incorporated. All rights reserved. TL4683 08/2015