Quest makes it easy 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/Neisseria gonorrhoeae

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 vaginalis

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

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

Mycoplasma genitalium infections may go unrecognized, either because infected individuals are asymptomatic or the symptoms are the same as those associated with other infections of the urogenital tract (eg, chlamydia, gonorrhea, or trichomoniasis). Accurate identification of a patient’s Mycoplasma genitalium infection status is critical for effective patient treatment for reproductive disorders.

Gram stain and culture are not clinically feasible methods of detection for Mycoplasma genitalium due to the pathogen’s lack of cell wall10 and fastidious nature.8 NAATs are preferred for detecting Mycoplasma genitalium because this pathogen cannot be visualized under a microscope and is prohibitively difficult to culture.11

Vaginitis

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 can also sometimes cause a vaginal discharge, but because the diagnostic tests and treatments for cervicitis are different from those for vaginitis, it is important to differentiate these conditions.12

Cervicitis

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

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs and often due to sexually transmitted infections including Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas 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.

Herpes

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 Screenings

Test name

Test code

CPT Codea

LABORATORY SCREENING

Chlamydia and gonorrhea

TEST NAME

Chlamydia/Neisseria gonorrhoeae RNA, TMA, Urogenital

TEST CODE

11363

CPT Codea

87491, 87591

LABORATORY SCREENING

Trichomonas vaginalis

TEST NAME

SureSwab®, CT/NG, T vaginalis

TEST CODE

16492

CPT Codea

87491, 87591, 87661

TEST NAME

SureSwab®, Trichomonas vaginalis RNA, Qualitative, TMA

TEST CODE

19550

CPT Codea

87661

TEST NAME

Trichomonas vaginalis RNA, Qualitative, TMA, Pap Vial

TEST CODE

90521

CPT Codea

87661

LABORATORY SCREENING

Mycoplasma genitalium

TEST NAME

SureSwab®, Mycoplasma genitalium, Real-Time PCR

TEST CODE

91475

CPT Codea

87563

LABORATORY SCREENING

Bacterial vaginosis/vaginitis

TEST NAME

SureSwab®, Bacterial Vaginosis/Vaginitis

TEST CODE

15509

CPT Codea

87481 (x4), 87512, 87661, 87799 (x3)

LABORATORY SCREENING

Vaginosis/vaginitis

TEST NAME

SureSwab®, Vaginosis/Vaginitis Plus

TEST CODE

17333

CPT Codea

87481 (x4), 87491, 87512, 87591, 87661, 87799 (x3)

LABORATORY SCREENING

Cervicitis

TEST NAME

Sexually-Transmitted Infections (STIs) Cervicitis Panel

TEST CODE

36962

CPT Codea

87491, 87591, 87661, 87563

LABORATORY SCREENING

Pelvic inflammatory disease (PID)

TEST NAME

Sexually-Transmitted Infections (STIs)
Pelvic Inflammatory Disease (PID) Panel

TEST CODE

36965

CPT Codea

87491, 87591, 87661, 87563

LABORATORY SCREENING

Herpes simplex virus 1/2 for lesions

TEST NAME

SureSwab®, Herpes Simplex Virus, Type 1 and 2 mRNA,TMA

TEST CODE

90570

CPT Codea

87529 (x2)

LABORATORY SCREENING

Herpes simplex virus 1/2

TEST NAME

Herpes Simplex Virus 1 and 2 (IgG), Type-Specific Antibodies

TEST CODE

6447

CPT Codea

86695, 86696

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