Quad Testing (time frame for testing)
Lily Dalke
Quad Screen
Test Code
30294
CPT Code(s)
82105, 82677, 84702, 86336 or 81511*
*The 2013 AMA CPT codebook
contains the component CPT codes and the new MAAA codeset. Please direct
any questions regarding coding to the payor being billed.
Includes
AFP, unconjugated Estriol, hCG, Dimeric Inhibin A and Maternal Risk Interpretation
Preferred Specimen(s)
3 mL serum
Minimum Volume
1 mL
Collection Instructions
Prenatal risk assessment for open neural tube defects (NTDs), Down syndrome, and trisomy 18.
The Quad Screen in
pregnant women should be performed between 15.0 and 22.9 weeks
gestational age, although the optimal period is 15.0-16.9 weeks.
This time frame allows sufficient opportunity for further diagnostic
studies if the initial Quad Screen results are abnormal. Specimens
submitted before 15.0 weeks or after 22.9 weeks gestation cannot be
properly evaluated for open neural tube defects, Down syndrome or
trisomy 18. Because Quad Screen results are influenced by certain
patient characteristics, the following data must be provided with the
specimen in order to permit accurate interpretation of results: date of
collection, patient’s (maternal) date of birth, patient’s estimated date
of delivery (EDD), patient’s weight (in lbs.), patient’s race,
patient’s diabetic status (is patient-insulin dependent prior to
pregnancy), number of fetuses, and whether this is a repeat sample.
Unacceptable: Samples from women carrying more than
2 fetuses (triplets, etc.). For NTD risk assessment in triplet
pregnancies, order Maternal Serum AFP (test code 5059).
Transport Container
Serum Separator Tube (SST®)
Clinical Significance
Maternal serum Quad Screen is used for prenatal screening of Down syndrome (Trisomy 21), Trisomy 18 (Edwards syndrome), and open neural tube defects (ONTD). This profile includes alpha-fetaprotein (AFP), unconjugated estriol (µE3), human chorionic gonadotropin (hCG), and inhibin A. Establishing risk for fetal Down syndrome, using the quad screen achieves a 70-75% detection rate with a 5% false positive rate. Screening for Trisomy 18 detects 60% of affected fetuses with a 0.2% false positive rate. MSAFP screening detects 88% of anencephaly and 79% of open spina bifida with a 3% false positive rate. Normal results do not ensure birth of a normal infant. In addition, 2-3% of newborns have some type of physical or mental defect, many of which may be undetectable with current prenatal diagnostic procedures.
Alternative Names(s)
AFP Quad Screen, Alpha-Fetoprotein, Maternal Serum
