Does anyone else had trouble to get the hbsag count test done in the US?

[itac]

I live in California, and have Anthem Blue Cross HMO. Currently assigned to Regal Medical Group. It seems like they are contracted with a lab called Quest Diagnostics, that run all the blood test work.

I went to my PCP a week and a half ago to get the follow-up test for hep b, after having the initial test diagnosis.
I asked for hbsag count, hbv dna count, hbeag and hbeag antibody (I already got the rest). They took my blood and sent it to Quest.

Yesterday I finally got the full report of that test, and it only had hbv dna count in ui/ml, but there was nothing about hbsag count or hbeag/hbeag antibody. I called my PCP office, the nurse who took the blood said to call to Quest to clarify the results if I think something is missing. I wasted 2 hours on the phone with 3 different people from Quest Diagnostics, none of them knew what I was talking about (hbsag in ui/ml, hbeag, hbeag antibody). They say they couldn't find these tests on their list of tests they provide. How is it possible? I would think such basic tests should be available, but I guess it's not the case with Quest? Did anyone else had to run blood work with this lab and ran into similar issues?

I asked them to have a technical person or a medical director to call me back about the tests that I want that were not "available".

Other tests I asked them that about that they didn't have:
Hepatitis A IgG antibody (to see if I've been exposed to the virus), the only have the IgM once which only checks for a recent exposure, but it's pointless cause what if I want to get the vaccination and need to know if I don't have the virus already? Doesn't make any sense...

Another test I asked them about that my GI asked me to get at their lab was "Fibrosis blood test" which they also couldn't find in their list.

I also wanted them to test for Hepatitis D to see if I got a co-infection, they said they only have "Hepatitis D virus RNA qualitative PCR" test... Not sure if that's the one that test for it or is it something else?

I didn't even get to ask them about the hbv genotype test... which my guess they wouldn't have that as well...

I will wait for them call from them to get clarifications, but feel free to leave your comments if you had similar experience. Thanks!

[ref88]

HBsAg quant test is still not offered in US. Probably no one will know what you're asking. I've found that it's rather difficult putting to practical use as a US patient some of the knowledge learned from this forum. My MD who is a participant is testing new drugs for big pharmaceuticals acknowledged to me that politics are to blame for the lack of offerings for this test.    

[terrywillbeok]

where do u live in california? it was suprised me , my doctor tested hbsag in ui/ml for me. I live in san fransisco.

[terrywillbeok]

I have been KP member since 2005. they never check out those for me too. they just check alt ast etc.... and also I dont know they check my hbvdna or not. everytime after blood test they just send me a note medicine control well.

[twinboys1girl4me]

I get all my labs at Sonora Quest or LabCorp.  You might try calling your insurance or doctors and ask if Sonora or LabCorp contracts with BC.  I believe both are in California (I'm in Arizona).  I have had no issues getting tested for Hep A and Hep D.  I believe the D you are trying to test is the correct one.  There is no quantitative Hbsag in the US, how unfortunate.  

I've found that if they don't know which tests I am talking about then I work with my doctors office to get the actual lab codes for them by looking online with my doctor.  I basically do their work, but whatever.  It seems odd they are having difficulty with that many labs.  All should be easily tested, except for the quant Hbsag, which is unfortunate because it is key.

Is the Fibrosis blood test actually the AFP, which is to test for liver cancer (but not a high accuracy so not totally reliable).  I can't think of another one, other than ALT, AST which are easy.  

Good luck and hope this helps!

[itac]

I live in Los Angeles. What Medical insurance/group do you have and what lab you got the absag quant from?

Thanks!

[itac]

twinboys1girl4me, what test did you get for hep a? Is that the hepatitis a Igg or Igm?

[terrywillbeok]

i need to double check on my report , i will let u know tomorrow. I have same insurance as u.

[terrywillbeok]

so u live in LA, have u done fibroscan?

[terrywillbeok]

this is for fibroscan in LA.  
  Address: 5901 W Olympic Blvd., Suite 401 Los Angeles, California 90036 (map)
Operating hours: Monday to Friday: 9:00am - 12:00pm & 1:30pm - 5:00pm
Call us at: 310-710-5220

[twinboys1girl4me]

The Hep A was: HEP A ANTIBODY, TOTAL and on the report the description says:

A positive result with total immunoglobulins (IgG and IgM) indicates a previous exposure to Hepatitis A either through infection or immunization.  It does not define present activity of the virus.  For additional serologic interpretation, presence or absence of Hepatitis A IgM antibody may be clinically helpful.

I was vaccinated, so my Hep A was positive.  This test was through Quest and I believe the test code is 102562.

As for the D: the test was HEPATITIS D ANTIBODY, TOTAL and also HEPATITIS D Virus IgM ANTIBODY, EIA.  Both were negative and was also tested through Sonora Quest.  

I also was tested for C: HEPATITIS C ANTIBODY, which was non-reactive through Sonora Quest also.

You also shouldn't have any issues with the HBeAg and HBeAb, I've been tested through those many times with Quest and LabCorp.  You can do a search online and get the codes for the lab they are sending to in California.  I've done that before when nobody knew what was what.  Hope this helps.

[mer971]

I live in Nyc and either here don;t do it, such a ridiculous cheap test. If  you have chance to travel outside USA, or you can send it via Fedex or UPS if you can effort it. I did it last summer in Europe.

[itac]

"this is for fibroscan in LA.  
  Address: 5901 W Olympic Blvd., Suite 401 Los Angeles, California 90036 (map)
Operating hours: Monday to Friday: 9:00am - 12:00pm & 1:30pm - 5:00pm
Call us at: 310-710-5220 "

Thanks for the place. Assuming we have the same insurance, can I go to my PCP and ask him to get a refferal for this fibroscan place?" will it be covered by the insurance? Is there a co-pay I will need to pay for it? Also, is it like an MRI or is it CT? I'm asking cause I want to know if there is any radiation involved doing this...

Thanks so much, and let me know what lab/medical group you used to get the hbsag in ui/ml... I hope I can find something too in la...

[itac]

Nvm I just checked on their website, and got an idea what kind of test is that:

http://www.fibroscanlosangeles.com/scheduleform-fibroscan.php

"FibroScan is now billable to insurance.

We accept Medicare and most PPO insurance policies.

Cash rates are available for patients with HMO insurance plans or no insurance."

It seems like they treat HMO insurance like no insurance, so I guess I will have to pay out of pocket, unless you know if you can get this procedure covered by the insurance, even if it's HMO?

[itac]

Hi twinboys1girl4me,

Could you please provide the links for the websites you are using to look up the codes for the tests? For Sonora, Quest and LabCorp...

I went to the Quest website:
http://www.questdiagnostics.com/home/patients/tests-a-z.html
To the section where it says for patients, all test a-z... I thought it's gonna be alphabetically list of the tests, but instead it just some highlight of some of the tests they provide but not full list or actual test names, found it to be confusing, perhaps there is another site?

Thanks!

[mer971]

you can do MRI, it's covered from insurance,and has no radiation. MRI is very accurate.

[itac]

Does FibroScan has radiation?

[itac]

thanks mer971, I will consider that too. Is that called MRI of the Liver?
It seems like I can get either this or fibroscan with the same co-pay of $250... but I will need to get to pre-certified (prove it's medically nes).

[itac]

"where do u live in california? it was suprised me , my doctor tested hbsag in ui/ml for me. I live in san fransisco. "

Terry could you please share with us what lab you got the hbsag in ui/ml?

I just spoke with:
Quest Diagnostics
Arup Labs
Lab Corp
Scantibodies (they only do it for manufacturing)

None of them do this test.
Does anyone else know where the absag quan can be obtained in the LA area?

Thanks!

[itac]

twinboys1girl4me, thanks for the info, I was able to talk with quest client service with a knowledgeable person in regards to these tests... that's what I got:

hepatitis d virus rna qualitative pcr
test code: 34469

hepatitis d, total antibody
test code: 4990

Not sure if I should get both to check for hep d co-infection, or the first one should be enough?

hepatitis a total antibody
test code: 508 (seems to be different than the one you said: 102562, perhaps they changed the number).

hepatitis b genotype
test code: 10529

intact pth
test code: 8837

vitd25oh
test code: 92888

hbeag
test code: 555

hbeab
test code: 556

hepatitis e total
test code: 15085

They said they don't have hbsag quant only quali (that says reactive or non-reactive).

Also, they couldn't tell which test code is "fibrosis blood test" I tried to tell them AFP like you said, but they said they have too many in the system...

[luckyman316]

As everyone mentioned here. They don't do the quantitive test in USA. I live here too. I asked my doctor about this, since I am on a clinical trial. According to the clinical trial, they actually measure it with the test but it's "for lab use only" (and my doctor rolled his eyes at this, so he does not agree). Unfortunately, we're stuck here until they approve the use of this type of test. I

[twinboys1girl4me]

Wonderful job!!!  I'm sure the codes are different in Arizona and that HEP A was from years ago, so I'm sure codes are different where you are.  When I did look them up it was from the Quest website, where you put in the test name, location, and then it gave codes.  It sounds like you finally talked to someone who knows their stuff, good job!

As for the D, I don't know why the specialist ordered both and do not know enough about D to advise one over the other.

As for the AFP the Quest code I have is 8918, but do not think this is your code because I've compared your other codes and are different than mine.  I know each code is different based on lab location.  The test name for AFP Quest is Alpha-Fetoprotein, Tumor Marker.

If you use this link below you will be able to search and find the codes.  For instance, when I enter in AFP in the search the first one Alpha-Fetoprotein (AFP) and AFP-L3 is correct.  It will bring you  to a new page which gives specific information, but do not rely on the test code listed there.  You need to click on the 2nd tab "ordering info" and select your lab from the drop down and this will then populate the correct test code and CPT code.  You can cross verify your other lab codes by doing this too.  This is what I had to do when I needed to make sure my kids did not have HBV and the pediatrician had no clue, so I had to figure it out myself.  I looked up the codes just like I directed you to do, called the pediatrician back and gave her the test codes and all went through result and billing just fine!

http://www.questdiagnostics.com/testcenter/TestCenterHome.action

[itac]

Does anyone that lives in the US have experience with ordering the hbsag quant from abroad through FedEx/UPS? If so what service/website did you use and how much time it took you to get the result and what was the price? Also, how do you get to put your blood in a tube and mail it, do you need to go to a private lab for that or you can go to your pcp to ask for a tube with your blood, and then mail it yourself?

[twinboys1girl4me]

Did your specialist have any idea on when they will be forced to give us the quantitative results?  

I'm thinking down the road if/when meds to lower the Hbsag become available (ex: ARC-520, GS-9620) they will be forced to do this test but who knows?  My specialist just says it's not available with no other information.

[twinboys1girl4me]

I tried this.  You cannot go to any lab in the US and request your blood to be drawn.  You have to have a lab order from a doctor.  Without a lab order and an actual test code they will not just draw your blood and mail it off where you tell them.  I even tried e-mailing several labs in Mexico earlier this week but have never received an e-mail back.  I cannot just drive hours, show up, and expect this to work!  

What "may" work is if you do find an out of the country lab and then try and find a nurse (friend, friend of a friend, etc) to draw your blood and then work with the lab on getting the sample to  them.  I have heard that this test does not have to have frozen blood, but honestly cannot fathom how this theory of mine would really work.  Even if all this did work I would then question the results (was blood too old, was the test the correct machine, was the results even mine and accurate, etc).  So, even if this did work I don't know if I would be satisfied!

It's so sad and frustrating.  If I do end up hearing back from Mexico I will let you know.  This seems to be the most logical for us.