Reflex Testing Protocols
Reflex Testing is laboratory testing performed subsequent to initial test results, and used to further
identify significant diagnostic information for appropriate patient care. These are laboratory tests which,
if positive, require additional separate follow-up testing in order to have clinical value. The need for the
follow-up testing is implicit in the physician order. Reflex tests required by state, regulatory or
accreditation standards are also considered to be of this type.
Test List
Hep B Core, Total (86704) reflexes to Hep B Core, IgM (86705)
Hep A, Total (86708) reflexes to Hep A, IgM (86709)
Hep B Surface Antigen reflexes for Confirmation of Positive Hep B Surface Antigen status
RPR (4501) reflexes to RPR titer (4511) and (4512) send to State lab for confirmation
TSH (84443) if less than 0.4 or greater than 5.49, reflexes to Free T4 (84439)
ANA (9007), if positive, reflexes to ANA titer & Pattern
HIV, if screened Positive, is reflexed for confirmation to Western Blot.
ABO, Rh & RBC Antibody Screen (3204)– if Antibody screen is Positive, reflexed for Identification
Urinalysis (5999) if Cloudy, WBC, Blood, Protein, Nitrite are Positive – reflexed to Microscopic (59992)
Immunoassay Drug Screens (80101) –if positive, is reflexed to Gas Chromotography/Mass
Spectrometry (GC/MS) (80102). If GC/MS is not permitted due to financial or regulatory constraint,
80101 will be reflexed to Quantitative Analysis (82145, 82205, 82520, 80299, 80154, 82055, 83925,
83992). If quantitative analysis is not permitted due to financial or regulatory constraint, 80101 will be
reflexed to a repeat test with qualitative results to be reported either Pos/Neg or with raw data.
Published 9/22/10
