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Quest makes it easier to test your female patients for infections

 

Left untreated, STIs and other infections can have devastating consequences for women and their reproductive health. It’s for her protection.

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The insights you need to provide the best care for your patients

Chlamydia trachomatis and Neisseria gonorrheae are the 2 most commonly reported notifiable diseases in the United States. They are among the most prevalent of all STDs, and since 1994, have comprised the largest proportion of all STDs reported to Centers for Disease Control and Prevention.1

In 2018, there were 1,758,668 cases of Chlamydia trachomatis and 583,405 cases of Neisseria gonorrhoeae reported.2

Left untreated, chlamydia and gonorrhea may affect the upper reproductive tract, resulting in pelvic inflammatory disease (PID).3 PID can have devastating consequences for women, including:

  • Infertility3
  • Life-threatening ectopic pregnancy,3 the leading obstetrical cause of maternal mortality in the first trimester4,5
  • Chronic pelvic pain3

Trichomoniasis (trich) affects more than 3.7 million people across the country, making it the most prevalent nonviral sexually transmitted infection in the US.6 More than 11% of women 40 years of age and older are infected with trich. Rates are even higher in women with a history of STIs—with 3 in 10 testing positive for the infection.

Trich can live in your patient’s system for months to years if left untreated.

Most cases of trichomoniasis are asymptomatic. Without symptoms, patients are not always tested, so they remain contagious and can pass the infection to others.6 When symptoms do occur, they typically include:

  • Cervicitis, urethritis, vaginitis
  • Vaginal discharge that may be malodorous, yellow-green, with or without vulvar irritation

Mycoplasma genitalium is a sexually transmitted pathogen that causes inflammation of the urethra (urethritis) and cervix (cervicitis) and is associated with female pelvic inflammatory disease (PID) and other adverse sexual and reproductive health outcomes. The clinical presentation of Mycoplasma genitalium is similar to many other STIs, such as chlamydia, gonorrhea, and trichomoniasis.7

  • Mycoplasma genitalium is detected in 10%-30% of women with clinical cervicitis8
  • Identified in up to 22% of PID cases8
  • Infected patients are 2 times more likely to acquire HIV9

Vaginitis is the most common gynecologic diagnosis in the primary care setting, affecting 1 in 3 women in their lifetime, but diagnosing its cause can be challenging.

The 3 diseases most frequently associated with vaginitis are bacterial vaginosis (BV), caused by an overgrowth of bacteria including Gardnerella vaginalis and anaerobes; vaginal trichomoniasis (TV), caused by Trichomonas vaginalis; and vulvovaginal candidiasis, usually caused by Candida albicans.

Cervicitis is an inflammation of the cervix, the lower, narrow end of the uterus that opens into the vagina. Cervicitis can result from common sexually transmitted infections (STIs), including Mycoplasma genitalium, gonorrhea, chlamydia, trichomoniasis, and genital herpes. Possible symptoms of cervicitis include bleeding between menstrual periods, pain with intercourse or during a cervical exam, and abnormal vaginal discharge. However, it’s also possible to have cervicitis and not experience any signs or symptoms.

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs and often due to sexually transmitted infections including Chlamydia trachomatisNeisseria gonorrhoeaeTrichomonas vaginalis, and/or Mycoplasma genitalium.

Symptoms may include pain in the lower abdomen and pelvis, heavy vaginal discharge with an unpleasant odor, abnormal vaginal bleeding, and pain during intercourse.

Genital herpes is common in the United States. More than 1 out of every 6 people aged 14 to 49 years have genital herpes.13

Genital herpes is caused by 2 types of viruses: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). Oral herpes is usually caused by HSV-1 and can result in cold sores or fever blisters on or around the mouth. Oral herpes caused by HSV-1 can be spread from the mouth to the genitals through oral sex.

A comprehensive test menu for your female patients

Our comprehensive menu provides the tests you need for diagnosing patients who present with symptoms, so you can deliver the highest quality of care—from testing through follow-up.

Laboratory ScreeningTest nameTest codeCPT codea
ChlamydiaChlamydia trachomatis RNA, TMA, Urogenital1136187491
Chlamydia trachomatis RNA, TMA, Rectal1650587491
Chlamydia trachomatis RNA, TMA, Throat7004887491
GonorrheaNeisseria gonorrhoeae RNA, TMA, Urogenital1136287591
Neisseria gonorrhoeae RNA, TMA, Rectal1650487591
Neisseria gonorrhoeae RNA, TMA, Throat7004987591
Chlamydia and GonorrheaChlamydia/Neisseria gonorrhoeae RNA, TMA, Urogenital1136387491, 87591
Chlamydia/Neisseria gonorrhoeae RNA, TMA, Rectal1650687491, 87591
Chlamydia/Neisseria gonorrhoeae RNA, TMA, Throat7005187491, 87591
Trichomonas vaginalisSureSwab®, Trichomonas vaginalis RNA, Qualitative, TMA1955087661
Trichomonas vaginalis RNA, Qualitative, TMA, Pap Vial9052187661
Chlamydia, Gonorrhea and Trichomonas vaginalisSureSwab®, CT/NG, T vaginalis1649287491, 87591, 87661
Chlamydia/N. gonorrhoeae and T. vaginalis RNA, Qualitative, TMA, Pap Vial9144887491, 87591, 87661
Mycoplasma genitaliumMycoplasma genitalium, rRNA, TMA9147587563
Herpes simplex virus 1/2 for lesionsSureSwab®, Herpes Simplex Virus, Type 1 and 2 mRNA,TMA9057087529 (x2)
Herpes simplex virus 1/2 serologyHerpes Simplex Virus 1 and 2 (IgG), with Reflex to HSV-2 Inhibition1716986695, 86696
CervicitisSexually-Transmitted Infections (STIs) Cervicitis Panel3696287491, 87591, 87661, 87563
Pelvic inflammatory disease (PID)Sexually-Transmitted Infections (STIs) Pelvic Inflammatory Disease (PID) Panel3696587491, 87591, 87661, 87563
Genital LesionSexually-Transmitted Infections (STIs) Genital Lesion Panel3828687529 (x2), 87798
Syphilis lesionTreponema pallidum DNA, Qualitative Real-Time PCR1659587798
Syphilis serologyRPR (Diagnosis) with Reflex to Titer and Confirmatory Testing3612686592
Hepatitis CHepatitis C Antibody with Reflex to HCV, RNA, Quantitative, Real-Time PCR847286803
HPVHPV mRNA E6/E7, Rectal9193287624
HPV mRNA E6/E7, Rectal with Reflex to Genotypes, 16, 18/459281087624
HPV Genotypes 16, 18/45, Anal-Rectal9280787625
Cytology, non-gynecologicalCytology, Non-Gynecological, Fluid, Washings, Brushings or FNA1067688104, 88108, 88112, 88160, 88161, 88162, 87207, 88172, 88173, 88305
Vaginosis/vaginitisSureSwab®, Bacterial Vaginosis DNA, Quantitative, Real-Time PCR1001681513
SureSwab® Advanced Candida Vaginitis (CV), TMA1012187481*2
SureSwab® Advanced Candida Vaginitis (CV)/Trichomonas vaginalis (TV), TMA1002987481*2 87661
SureSwab® Advanced Bacterial Vaginosis (BV), CT/NG, TMA1012381513, 87491, 87591
SureSwab® Advanced Vaginitis, TMA1011981513 87481*2 87661
SureSwab® Advanced Vaginitis Plus, TMA1012081513 87481*2 87661 87491 87591

Components of panels can be ordered separately.

Test codes may vary by location. Please contact your local laboratory for more information.

a The CPT® codes provided are based on American Medical Association guidelines an 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.

 

​References:

  1. CDC. Sexually transmitted disease surveillance 2018. Chlamydia. Updated September 30, 2019. Accessed November 19, 2020. https://www.cdc.gov/std/stats18/chlamydia.htm
  2. CDC. Sexually transmitted diseases — reported cases and rates of reported cases, United States, 1941–2018. Updated August 20, 2019. Accessed November 19, 2020. https://www.cdc.gov/std/stats18/tables/1.htm
  3. Farley TA, Cohen DA, Elkins W. Asymptomatic sexually transmitted diseases: the case for screening. Prev Med. 2003;36(4):502-509. doi:10.1016/s0091-7435(02)00058-0
  4. Creanga AA, Shapiro-Mendoza CK, Bish CL, et al. Trends in ectopic pregnancy mortality in the United States: 1980–2007. Obstet Gynecol. 2011;117(4):837-843. doi:10.1097/AOG.0b013e3182113c10
  5. Tenore JL. Ectopic pregnancy. Am Fam Physician. 2000;61(4):1080-1088.
  6. CDC. 2015 Sexually Transmitted Diseases Treatment Guidelines. Trichomoniasis. Updated June 4, 2015. Accessed November 5, 2015. http://www.cdc.gov/std/tg2015/trichomoniasis.htm
  7. Falk L, Fredlund H, Jensen JS. Signs and symptoms of urethritis and cervicitis among women with or without Mycoplasma genitalium or Chlamydia trachomatis infection. Sex Transm Infect. 2005;81(1):73-78. doi:10.1136/sti.2004.010439
  8. CDC. 2015 Sexually Transmitted Diseases Treatment Guidelines. Emerging issues. Updated June 4, 2015. Accessed November 20, 2019. https://www.cdc.gov/std/tg2015/emerging.htm
  9. Napierala Mavedzenge S, Weiss HA. Association of Mycoplasma genitalium and HIV infection: a systematic review and meta-analysis. AIDS. 2009;23(5):611-620. doi:10.1097/QAD.0b013e328323da3e
  10. Egan ME, Lipsky MS. Diagnosis of vaginitis. Am Fam Physician. 2000;62(5):1095-1104.
  11. Workowski KA, Bolan GA, Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64(RR-03):1-137.
  12. CDC. 2015 Sexually Transmitted Diseases Treatment Guidelines. Diseases characterized by vaginal discharge. Updated June 4, 2015. Accessed November 21, 2020. https://www.cdc.gov/std/tg2015/vaginal-discharge.htm
  13. CDC. Genital herpes – CDC fact sheet. Updated August 28, 2017. Accessed November 20, 2020. https://www.cdc.gov/std/herpes/stdfact-herpes.htm

Universal screening with opt-out for CT/NG screening

The latest CDC Guidelines recommended considering universal screening with opt-out as part of routine care for all female patients ages 15 - 24.*
*Workowski KA, et al. MMWR. doi:10.15585/mmwr.rr7004a1

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Assessing high-risk patients

With rates of sexually transmitted infections (STIs) on the rise, assessing women who may be high-risk is more important than ever.

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STI webinar series

Listen to the experts as they discuss STI testing beyond Chlamydia trachomatis and Neisseria gonorrheae.

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