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3092: Quad Screen Print View
AFP IA    ng/mL 
AFP MoM CALC  < 2.50  MoM 
uE3 (unconjugated Estriol) ICMA    ng/mL 
uE3 (unconjugated Estriol) MoM CALC    MoM 
hCG IA    IU/mL 
hCG MoM CALC    MoM 
Inhibin A Value CL    pg/mL 
Inhibin A MoM CALC    MoM 
Down Syndrome Risk   > 269   
DOWN SYNDROME SCREEN   Negative   
Down Syndrome Interpretation      
Open Spina Bifida Risk      
OPEN SPINA BIFIDA SCREEN   Negative   
Open Spina Bifida Interpretation      
TRISOMY 18 SCREEN   Negative   
Comments      
Method of Estimation      
Number of Fetuses      
Weeks Gestation      
Race      
Weight      
Insulin Dependant Diabetes      
Date of Ultrasound      
Date of LMP      
Date of Birth      

PRIMARY
1 Serum 3 (1) mL   Room Temperature - 14 Day(s)/Frozen - 28 Day(s)/Refrigerated - 14 Day(s)  
ALTERNATE

The performance of this test varies with maternal age and other clinical parameters. Recent research suggests that second trimester maternal serum screening of alpha-fetoprotein, unconjugated estriol, human chorionic gonadotropin and inhibin A (the Quad Screen) has 81% sensitivity for Down syndrome detection and a false-positive rate of 7%. This use is considered to be investigational. Follow-up testing is recommended for patients when the calculated second trimester Down syndrome risk is greater than or equal to 1: 270. Normal serum AFP levels for neural tube defects (NTD) are less than 2.0 multiples of the median (MoM). Normal values exclude approximately 95% of cases of anencephaly, 80% of cases of spina bifida, and 85% of ventral wall defects. Closed dysraphic states and small defects generally constitute the group in which total exclusion is not possible.

Collect specimen between 14-22 weeks gestation. Icteric or
Grossly lipemic specimens are not acceptable.
Split serum into two tubes and ship on cold pack. If not shipped
immediately, samples should be frozen.
SPECIAL INSTRUCTIONS: Must include: Gestational age, LMP, Weight,
Race, Insulin dependent, number of fetuses, and initial or
repeat screen.
Setup Schedule
Sunday, Tuesday-Saturday

Reported (Analytical Time)
Same day

CPT Codes
82105,82677,84702,86336

The CPT codes provided are based on AMA 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.

Notes
Reject criteria: Gross hemolysis; grossly lipemic Transport Temperature: Room temperature






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