The right test at the right time

The following pages are a reference to the age-based well-woman screening recommendations from both ACOG and the CDC, with the corresponding Quest tests. Together, it helps to ensure your patients get the testing they need at every well-woman visit at every age.



PERIODIC SCREENING

Ages 13-18 1, d

ACOG RECOMMENDATIONS CORRESPONDING QUEST TEST(S) TEST CODE
Annual chlamydia and gonorrhea testing (if sexually active) Chlamydia trachomatis/Neisseria gonorrhoeae RNA, TMA (Aptima® collection) 11363
Human immunodeficiency virus (HIV) testing (if sexually active)a HIV-1/2 Antigen and Antibodies, Fourth Generation, with Reflexesb 91431


ADDITIONAL CDC RECOMMENDATIONS CORRESPONDING QUEST TEST(S) TEST CODE
Screening for chlamydia and gonorrhea (if sexually active) Chlamydia trachomatis/Neisseria gonorrhoeae RNA, TMA (Aptima collection) 11363
Screening for trichomonas when risk factors are identifiede SureSwab® Trichomonas vaginalis RNA, Qualitative TMA 19550

Ages 19-39 2

ACOG RECOMMENDATIONS CORRESPONDING QUEST TEST(S) TEST CODE
Annual chlamydia and gonorrhea testing (under 25 and if sexually active and for older women who are at increased risk for infectiond) Chlamydia trachomatis/Neisseria gonorrhoeae RNA, TMA (Aptima collection) 11363
Cervical Cancer Screening Recommended to start at age 21
  1. In women 21–65 years of age:
    • Cervical cytology (Pap) alone every 3 years (Reflex to HPV if Pap is ASC-US)
  2. In women 30–65 years of age:
    • Co-testing with Pap and HPV together every 5 years (preferred)
    • Or
    • Pap alone every 3 years (Reflex to HPV if Pap is ASC-US)

Image-Guided Pap w. Age-Based Screening Protocols

Image-Guided Pap w. Age-Based Screening, Plus CT/NG


Image-Guided Pap w. Age-Based Screening, Plus CT/NG/Trich


Pap alone

91384c


91385c



91386c



See note belowc
Human immunodeficiency virus (HIV) testinga HIV-1/2 Antigen and Antibodies, Fourth Generation, with Reflexesb 91431


ADDITIONAL CDC RECOMMENDATIONS CORRESPONDING QUEST TEST(S) TEST CODE
Screening for chlamydia and gonorrhea (under age 25 and if sexually active; for ages 25 and over when risk factors are identifiede) Chlamydia trachomatis/Neisseria gonorrhoeae RNA, TMA (Aptima collection) 11363
Screening for trichomonas when risk factors are identifiede SureSwab Trichomonas vaginalis RNA, Qualitative TMA 19550

a. Healthcare providers should always follow state HIV screening requirements. For more information, visit www.cdc.gov and search for the September 22, 2006 issue of MMWR Recommendations and Reports.
b. Reflex testing may be performed at an additional charge.
c. The age-based (Smart Codes) offerings are based on ACOG recommendations and include image-guided Pap tests. The ACOG guidelines do not specify a particular type of Pap test. Both imaged and non-imaged Pap tests are acceptable under the guidelines. Non-imaged Paps, conventional Paps, as well as additional testing recommended by the guidelines, may be ordered individually and are available at Quest Diagnostics. Test codes may vary by location. Please contact your local laboratory or go to QuestDiagnostics.com/TestDirectory for more information.
d. Positive results may need to be reported to the authorities under applicable law.
Additional assessments and recommendations may be necessary for patients with certain risk factors. For more information, visit acog.org and search for Well-Woman Recommendations.
e. The top risk factors are inconsistent use of condoms, multiple sex partners, and previous STI infection.



PERIODIC SCREENING

Ages 40-64 3

ACOG RECOMMENDATIONS CORRESPONDING QUEST TEST(S) TEST CODE
Annual mammography N/A N/A
Diabetes testing every 3 years after age 45 Glucose
Hemoglobin A1c
Cardio IQ® Diabetes Risk Panel (with Score)a*
Diabetes Risk Panel (with Score)*
Cardio IQ® Insulin Resistance Panel (with Score)*
67777W
496X
92026

92027
36509
Cervical Cancer Screening
  • Co-testing with Pap and HPV together every 5 years (preferred)
  • Or
  • Pap alone every 3 years (Reflex to HPV if Pap is ASC-US)

Image-Guided Pap w. Age-Based Screening Protocols
Image-Guided Pap w. Age-Based Screening, Plus CT/NG
Image-Guided Pap w. Age-Based Screening, Plus CT/NG/Trich
Pap alone

91384b

91385b

91386b

See note belowb
Lipid profile assessment every 5 years beginning at age 45 Lipid Panel*
Cardio IQ ASCVD Risk Panel (with Score)a*
ASCVD Risk Panel (with Score)*
Cardio IQ Advanced Lipid Panel with Inflammation*
968T
92052

92053
94220
Thyroid-stimulating hormone testing every 5 years beginning at age 50 TSH (without Reflex)
TSH with Reflex to Free T4
Thyroid Panel with TSH*
30163E
36127
7444
Colorectal cancer screening with colonoscopy every 10 years beginning at age 50 or at age 45 for African-American women (preferred); fecal immunochemical test (FIT) annually starting at age 50 as an alternative to colonoscopy InSure® ONE 11290
Human immunodeficiency virus (HIV) testingc HIV-1/2 Antigen and Antibodies, Fourth Generation, with Reflexesd 91431
One-time hepatitis C testing for persons born from 1945 through 1965 and unaware of their infection status Hepatitis C Antibody with Reflex to HCV RNA 8472

a. To learn more about our Cardio IQ testing, visit QuestDiagnostics.com/CardioIQ.
b. The age-based offerings are based on ACOG recommendations and include image-guided Pap tests. The ACOG guidelines do not specify a particular type of Pap test. Both imaged and non-imaged Pap tests are acceptable under the guidelines. Non-imaged Paps, conventional Paps, as well as additional testing recommended by the guidelines, may be ordered individually and are available at Quest Diagnostics. Test codes may vary by location. Please contact your local laboratory or go to QuestDiagnostics.com/TestDirectory for more information.
c. Healthcare providers should always follow state HIV screening requirements. For more information, visit cdc.gov, and search for the September 22, 2006 issue of MMWR™ Recommendations and Reports.
d. Reflex testing may be performed at an additional charge.
Additional assessments and recommendations may be necessary for patients with certain risk factors. For more information, visit acog.org, and search for Well-Woman Recommendations.

Rely on BRCAvantage from Quest Diagnostics

ACOG recommends that OB/GYNs perform a hereditary cancer risk assessment to help identify patients who may be at risk of developing certain types of cancer.4 When you have a patient with a family or personal history of breast or ovarian cancer or Ashkenazi Jewish ancestry, BRCA testing can give you the valuable information you need to make the best treatment decisions. Our BRCAvantage testing is performed on a next-generation sequencing platform in conjunction with our proprietary software to allow for the most accurate identification of disease. Ask your Quest Diagnostics sales representative for more information, or visit BRCAvantage.com.

Ages 40-64 4

ADDITIONAL CDC RECOMMENDATIONS CORRESPONDING QUEST TEST(S) TEST CODE
Screening for chlamydia, gonorrhea, and trichomonas when risk factors are identifieda Chlamydia trachomatis/Neisseria gonorrhoeae RNA, TMA (Aptima collection)
SureSwab Trichomonas vaginalis RNA, Qualitative TMA
11363


19550

a. The top risk factors are inconsistent use of condoms, multiple sex partners, and previous STI infection.



PERIODIC SCREENING

Ages 65-older 5

ACOG RECOMMENDATIONS CORRESPONDING QUEST TEST(S) TEST CODE
Annual mammography N/A N/A
Annual urinalysis Urinalysis, Macroscopic
Urinalysis with Reflex Microscopic
232A
86702A
Bone mineral density screening with bone densitometry every 2 years, unless new risk factors are present N/Aa N/Aa
Diabetes testing every 3 years Glucose
Hemoglobin A1c
Cardio IQ® Diabetes Risk Panel (with Score)b*
Diabetes Risk Panel (with Score)*
Cardio IQ Insulin Resistance Panel (with Score)*
67777W
496X
92026

92027
36509
Lipid profile assessment every 5 years Lipid Panel*
Cardio IQ ASCVD Risk Panel (with Score)b*
ASCVD Risk Panel (with Score)*
Cardio IQ Advanced Lipid Panel with Inflammation*
968T
92052

92053
94220
Thyroid-stimulating hormone testing every 5 years TSH (without Reflex)
TSH with Reflex to Free T4
Thyroid Panel with TSH*
30163E
36127
7444
Colorectal cancer screening with colonoscopy every 10 years, beginning at age 45. Fecal immunochemical test (FIT) annually, starting at age 50 as an alternative to colonoscopy InSure® ONE 11290
Cervical Cancer Screening
  • Cervical cytology (Pap) should be discontinued in women with evidence of adequate negative prior screening results (3 consecutive negative cytology results or 2 consecutive negative co-test results within the previous 10 years, with the most recent test performed within the past 5 years). No history of CIN 2 or higher
  • Recommend continuing age-based screening for patients greater than or equal to 21 years of age with a history of CIN 2, CIN 3, or adenocarcinoma in situ
Image-Guided Pap with Age-Based Screening Protocols (only if indicated by patient history) 91384c
One-time hepatitis C testing for persons born from 1945 through 1965 and unaware of their infection status Hepatitis C Antibody with Reflex to HCV RNA 8472

a. Lab testing may be useful in the therapeutic management of osteoporosis: Collagen Cross-Linked N-Telopeptide (NTx), urine: 36167(X) and Collagen Type 1 C-Telopeptide (CTx): 17406(X).
b. To learn more about our Cardio IQ testing, visit QuestDiagnostics.com/CardioIQ.
c. The age-based offerings are based on ACOG recommendations and include image-guided Pap tests. The ACOG guidelines do not specify a particular type of Pap test. Both imaged and non-imaged Pap tests are acceptable under the guidelines. Non-imaged Paps, conventional Paps, as well as additional testing recommended by the guidelines, may be ordered individually and are available at Quest Diagnostics. Test codes may vary by location. Please contact your local laboratory, or go to QuestDiagnostics.com/TestDirectory for more information.
Additional assessments and recommendations may be necessary for patients with certain risk factors. For more information, visit acog.org, and search for Well-Woman Recommendations.

Ages 65-older 5

ADDITIONAL CDC RECOMMENDATIONS CORRESPONDING QUEST TEST(S) TEST CODE
Screening for chlamydia, gonorrhea, and trichomonas when risk factors are identifieda Chlamydia trachomatis/Neisseria gonorrhoeae RNA, TMA (Aptima collection)
SureSwab® Trichomonas vaginalis RNA, Qualitative TMA
11363


19550

a. The top risk factors are inconsistent use of condoms, multiple sex partners, and previous STI infection.

*PANEL COMPONENTS

Diabetes Risk Panel (with Score)
Includes:
Glucose
Hemoglobin A1c
Total Cholesterol
HDL cholesterol
Triglycerides
Non-HDL and Calculated Components
8 Year Diabetes Risk

Cardio IQ® Diabetes Risk Panel (with Score)
Includes:
Cardio IQ® Glucose
Cardio IQ® Hemoglobin A1c
Cardio IQ® Total Cholesterol
Cardio IQ® HDL cholesterol
Cardio IQ® Triglycerides
Cardio IQ® Non-HDL and Calculated Components
Cardio IQ® 8 Year Diabetes Risk


Cardio IQ® Insulin resistance Panel (with Score)
Includes:
Insulin, Intact LC/MS/MS
C-Peptide, LC/MS/MS
Insulin Resistance Score

Lipid Panel
Includes:
Cholesterol, Total
Triglycerides
HDL Cholesterol
LDL-Cholesterol (calculated)
Cholesterol/HDL Ratio (calculated)
Non-HDL Cholesterol (calculated)
Cardio IQ® Risk Panel (with Score)
Includes:
Cardio IQ® Cholesterol, Total
Cardio IQ® HDL Cholesterol
Cardio IQ® Triglycerides
Cardio IQ® Non-HDL and Calculated Components
Cardio IQ® Direct LDL
Cardio IQ® ASCVD Risk Scores

ASCVD Risk Panel (with Score)
Includes:
Cholesterol, Total
HDL Cholesterol
Triglycerides
Non-HDL and Calculated Components
Cholesterol, Direct LDL
ASCVD Risk Scores

Cardio IQ® Advanced Lipid Panel with Inflammation
Includes:
Cardio IQ® Cholesterol, Total
Cardio IQ® HDL Cholesterol
Cardio IQ® Triglycerides
Cardio IQ® Non-HDL and Calculated Components
Cardio IQ® Lipoprotein Fractionation, Ion Mobility
Cardio IQ® Apolipoprotein B
Cardio IQ® Lipoprotein (a)
Cardio IQ® hs-CRP
Cardio IQ® Lp-PLA2 Activity

Thyroid Panel
Includes:
T3 Uptake
T4 (thyroxine) Total
Free T4 Index (T7)
TSH


References:
1. The American College of Obstetricians and Gynecologists. Ages 13–18 years: laboratory and other tests. https://acog.org/About-ACOG/ACOG-Departments/Annual-Womens-Health-Care/Well-Woman-Recommendations/Laboratory-Testing-Ages-13-18-Years. Accessed September 23, 2019.
2. The American College of Obstetricians and Gynecologists. Ages 19–39 years: laboratory and other tests. https://acog.org/About-ACOG/ACOG-Departments/Annual-Womens-Health-Care/Well-Woman-Recommendations/laboratory-testing-Ages-19-39-Years. Accessed September 23, 2019.
3. The American College of Obstetricians and Gynecologists. Ages 40–64 years: laboratory and other tests. https://acog.org/About-ACOG/ACOG-Departments/Annual-Womens-Health-Care/Well-Woman-Recommendations/Laboratory-Testing-Ages-40-64-Years. Accessed September 23, 2019.
4. The American College of Obstetricians and Gynecologists. Committee opinion no. 634: hereditary cancer syndromes and risk assessment. Obstet Gynecol. 2015;125(6):1538-1543.
5. The American College of Obstetricians and Gynecologists. Ages 65 years and older: laboratory and other tests. http://acog.org/About-ACOG/ACOG-Departments/Annual-Womens-Health-Care/Well-Woman-Recommendations/laboratory-testing-Ages-65-years-and-older. September 23, 2019.