SARS-CoV-2 (COVID-19) by RT-PCR, High Risk

Test Name SARS-CoV-2 (COVID-19) by RT-PCR, High Risk
Test Code 782
CPT Code(s) 87635
Preferred Requirement(s) Nasopharyngeal Swab or Oropharyngeal Swab

-Viral or Universal Transport Media (VTM, UTM, or M4RT) or ESwab (Plastic shaft with white cap) with Swab.

Alternate Requirements(s) Bronchoalveolar Lavage, Tracheal Aspirate, or Sputum
Unacceptable Specimens Calcium alginate swabs. Swabs with wooden shafts. Specimens submitted without completed requisition and CDC COVID-19 PUI Case Report Form.
Preferred Transport Temperature Critical Refrigerated: 72 Hours
*If specimen will not reach the laboratory within 72 hours of collection, freeze and ship on dry ice.
Alternate Transport Temperature Frozen: 1 Week

Ambient: 48 Hours
*If specimen will not reach the laboratory within 48 hours of collection, refrigerate specimen.

Ordering Recommendation For presumptive qualitative detection of nucleic acid from the 2019-Novel Coronavirus (SARS-CoV-2) in upper and lower respiratory specimens collected from individuals considered at high risk for infection or with high risk epidemiologic factors.

Submission of a completed CDC COVID-19 PUI Case Report Form is required. Specimens submitted without a completed form may be delayed.

Special Instructions Submit one specimen per patient in an individually sealed bag. Clearly indicate source on container or accompanying paperwork.

Nasopharyngeal Swab (recommended by CDC for initial diagnosis of COVID-19):
Insert a swab into the nostril parallel to the palate. Leave the swab in place for a few seconds to absorb secretions. Place swab immediately into UTM (viral transport media).

NOTE: Use only synthetic fiber swabs with plastic shafts. Flocked swabs are acceptable. Do not use calcium alginate swabs or swabs with wooden shafts, as they may contain substances that inactivate some viruses and inhibit PCR testing.

*SARS-CoV-2 testing can be performed on any viral transport media that has the following characteristics: maintains viability of viruses, chlamydiae, mycoplasmas and ureaplasmas; is osmotically balanced and buffered; contains Hank’s balanced salt solution with a pH indicator; uses sucrose as a preservative; contains protein and gelatin as stabilizers; contains antimicrobial agents to minimize commensal bacterial and fungus contamination. M4RT media must be kept at refrigerated or frozen temperature after collection because of limited room temperature stability of SARS-CoV-2 samples. Room temperature transport of M4RT media is only appropriate prior to sample inoculation (this is a common cause of confusion with M4RT).

Oropharyngeal Swab (e.g., throat swab):
Swab the posterior pharynx, avoiding the tongue. Place swab immediately into UTM (viral transport media). *If collected, combine in tube with nasopharyngeal swab.

Bronchoalveolar Lavage, Tracheal Aspirate:
Collect 2-3 mL into a sterile, leak-proof, screw-cap sputum collection cup or sterile dry container. Refrigerate specimen at 2-8°C and ship overnight on ice pack. If specimen will not reach the laboratory within 72 hours of collection, freeze and ship on dry ice.

Sputum:
Have the patient rinse the mouth with water and then expectorate approximately 1 mL deep cough sputum directly into a sterile, leak-proof, screw-cap sputum collection cup or sterile dry container.
NOTE: Induction of sputum is not recommended.

Methodology Real-Time Polymerase Chain Reaction (RT-PCR)
Days Performed Sun, Mon, Tues, Wed, Thurs, Fri, Sat
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