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  • /Hepatitis B Surface Antigen (HBsAg), Qualitative or Quantitative

Hepatitis B Surface Antigen (HBsAg), Qualitative or Quantitative
Medical Test

Diseases (52)
Screening/Initial Testing (6)
Diagnostic Testing (42)
Liver Disease
10
Note:

Rule out hepatitis B virus infection.

Acute liver failure
9
Note:

Rule out Hepatitis B.

Alcoholic hepatitis
9
Note:

Rule out hepatitis B.

Hepatocellular carcinoma
8
Note:

Differential diagnosis of HBV infection.

Acute hepatic failure
7
Note:

Rule out hepatitis B virus infection.

Alcoholic fatty liver
7
Note:

R/O Hepatitis B

Chronic liver disease
7
Note:

Differential diagnosis of hepatitis B viral infection.

Idiopathic thrombocytopenic purpura
7
Note:

In patients considered for rituximab therapy.

Viral hepatitis
7
Note:

Rule out hepatitis B infection.

Cryoglobulinemia
6
Note:

Rule out Hepatitis B caused cryoglobulinemia.

Cryptogenic cirrhosis
6
Note:

Rule out hepatitis B.

Drug dependence
6
Note:

Rule out hepatitis B infection in patients using needles.

End stage renal disease
6
Note:

Screening for infection with Hepatitis B virus due to dialysis.

Follicular lymphoma
6
Note:

Rule out hepatitis B infection.

Granulomatosis with polyangiitis (Wegener's)
6
Note:

Rule out hepatitis B infection.

Hodgkin Lymphoma
6
Note:

Rule out hepatitis B.

IgA nephropathy
6
Note:

If evidence of liver disease is present.

Jaundice
6
Note:

R/O Viral hepatitis in patients with evidence of hepatocellular injury

Malignant neoplasm, extrahepatic bile duct
6
Note:

Rule out hepatitis B.

Malignant neoplasm, intrahepatic bile duct
6
Note:

Rule out hepatitis B.

Opioid Dependence
6
Note:

Rule out hepatitis B infection in patients using IV heroin.

Peritoneal effusion
6
Note:

Rule out hepatitis B.

Polyarteritis nodosa
6
Note:

Rule out Hepatitis B virus infection.

Systemic granulomatous vasculitis (Churg-Strauss syndrome)
6
Note:

Rule out vasculitis caused by hepatitis B.

Thrombotic thrombocytopenic purpura
6
Note:

Rule out hepatitis B.

Acetaminophen overdose
5
Note:

Rule out hepatitis B infection.

Chronic kidney disease
5
Note:

Rule out hepatitis B.

Disease Management Testing (3)
Other Supportive/Alternative Tests (1)
Mantle cell lymphoma
6
Note:

Hepatitis B testing should be ordered in patients for whom rituximab is being considered.

Overview

Hepatitis B infection is caused by the Hepatitis B Virus. Hepatitis B virus is spread by contact with contaminated blood and body fluids. Chronic infection with Hepatitis B virus results in damage to the liver, cirrhosis and/or liver cancer. The body’s immune system is responsible for the liver tissue damage because it destroys the liver cells containing the virus. Consumption of alcohol during infection with Hepatitis B virus is discouraged because it can increase the damage to the liver. Hepatitis B virus is prevented by cautious and safe handling of blood and body fluids, vaccination, and refraining from behavior known to be associated with acquisition of the virus. Serology testing to detect hepatitis B surface antigen (HBsAg) is the standard for diagnosing the disease.

In hepatitis B virus infection, surface antigen is detectable 2 – 5 weeks before onset of symptoms, rises in titer, and peaks at about the time of onset of clinical illness. Generally it persists for 1 – 5 months, declining in titer and disappearing with resolution of clinical symptoms. HBsAg is a first-line test for the diagnosis of acute or chronic hepatitis B. If positive, no other test is needed. HBsAg is an indicator for active infection. It is a marker used for detecting initial infection, monitoring the course of the infection, and progression to chronic disease. It is also used in the screening of donor blood.

Clinical Utility
  • Diagnosis of HBV infection
  • Diagnosis of HBV active infection
  • Monitoring the course of the infection and progression to chronic disease
  • Blood donor screening

Interpretation

Positive in:

  • Acute hepatitis B
  • Chronic hepatitis B (persistence of HBsAg for >6 months)
  • HBsAg-positive carriers

Note: In rare cases HBsAg might be negative (when tested early). If clinical suspicion is high, HBcAb (IgM) test is then indicated.

Reference Ranges

Negative (Non-reactive)

 

Methodology

Enzyme immunoassay, Chemiluminescence immunoassay.

Specimen Collection

Serum (SST) or Plasma EDTA (Lavender) or Plasma Heparin

Stability:

  • Ambient: 5 days
  • Refrigerated: 14 days
  • Frozen: 60 days

Additional Testing

HBsAg is definitive for diagnosing infection with Hepatitis B Virus. Other tests useful in monitoring HBV Infection: Total Anti-HBc, HBeAg, HBV DNA, Liver Function Tests, Lactate Dehydrogenase, Liver Biopsy.

CPT
87340$10.33
87341$10.33
87467$0

ICD10
ICD CODE AND DESCRIPTIONLCD CODENCD CODE
A15 - Respiratory tuberculosis——
A15.0 - Tuberculosis of lung——
A17 - Tuberculosis of nervous system——
A18 - Tuberculosis of other organs——
A18.11 - Tuberculosis of kidney and ureter——
A19 - Miliary tuberculosis——
A19.0 - Acute miliary tuberculosis of a single specified site——
A19.1 - Acute miliary tuberculosis of multiple sites——
A19.2 - Acute miliary tuberculosis, unspecified——
A19.9 - Miliary tuberculosis, unspecified——
A31 - Infection due to other mycobacteria——
B02 - Zoster [herpes zoster]——
B02.23 - Postherpetic polyneuropathy——
B15 - Acute hepatitis A——
B16 - Acute hepatitis B——
B16.9 - Acute hepatitis B without delta-agent and without hepatic coma——
B17 - Other acute viral hepatitis——
B17.0 - Acute delta-(super) infection of hepatitis B carrier——
B17.8 - Other specified acute viral hepatitis——
B18 - Chronic viral hepatitis——
B18.0 - Chronic viral hepatitis B with delta-agent——
B18.1 - Chronic viral hepatitis B without delta-agent——
B18.2 - Chronic viral hepatitis C——
B18.8 - Other chronic viral hepatitis——
B18.9 - Chronic viral hepatitis, unspecified——
B19 - Unspecified viral hepatitis——
B19.0 - Unspecified viral hepatitis with hepatic coma——
B19.1 - Unspecified viral hepatitis B——
B19.10 - Unspecified viral hepatitis B without hepatic coma——
B19.11 - Unspecified viral hepatitis B with hepatic coma——
B19.2 - Unspecified viral hepatitis C——
B19.9 - Unspecified viral hepatitis without hepatic coma——
B25.1 - Cytomegaloviral hepatitis——
B26.81 - Mumps hepatitis——
B58.1 - Toxoplasma hepatitis——
B90 - Sequelae of tuberculosis——
C22 - Malignant neoplasm of liver and intrahepatic bile ducts——
C22.0 - Liver cell carcinoma——
C22.1 - Intrahepatic bile duct carcinoma——
C22.7 - Other specified carcinomas of liver——
C22.8 - Malignant neoplasm of liver, primary, unspecified as to type——
C22.9 - Malignant neoplasm of liver, not specified as primary or secondary——
C24 - Malignant neoplasm of other and unspecified parts of biliary tract——
C24.0 - Malignant neoplasm of extrahepatic bile duct——
C77 - Secondary and unspecified malignant neoplasm of lymph nodes——
C77.8 - Secondary and unspecified malignant neoplasm of lymph nodes of multiple regions——
C77.9 - Secondary and unspecified malignant neoplasm of lymph node, unspecified——
C78.7 - Secondary malignant neoplasm of liver and intrahepatic bile duct——
C81 - Hodgkin lymphoma——
C81.0 - Nodular lymphocyte predominant Hodgkin lymphoma——

Additional ICD10
ICD CODE AND DESCRIPTIONLCD CODENCD CODE
A06.4 - Amebic liver abscess——
A15.0 - Tuberculosis of lung——
A15.4 - Tuberculosis of intrathoracic lymph nodes——
A15.5 - Tuberculosis of larynx, trachea and bronchus——
A15.6 - Tuberculous pleurisy——
A15.7 - Primary respiratory tuberculosis——
A15.8 - Other respiratory tuberculosis——
A15.9 - Respiratory tuberculosis unspecified——
A17.0 - Tuberculous meningitis——
A17.1 - Meningeal tuberculoma——
A17.8 - Other tuberculosis of nervous system——
A17.81 - Tuberculoma of brain and spinal cord——
A17.82 - Tuberculous meningoencephalitis——
A17.83 - Tuberculous neuritis——
A17.89 - Other tuberculosis of nervous system——
A17.9 - Tuberculosis of nervous system, unspecified——
A18.0 - Tuberculosis of bones and joints——
A18.01 - Tuberculosis of spine——
A18.02 - Tuberculous arthritis of other joints——
A18.03 - Tuberculosis of other bones——
A18.09 - Other musculoskeletal tuberculosis——
A18.1 - Tuberculosis of genitourinary system——
A18.10 - Tuberculosis of genitourinary system, unspecified——
A18.11 - Tuberculosis of kidney and ureter——
A18.12 - Tuberculosis of bladder——
A18.13 - Tuberculosis of other urinary organs——
A18.14 - Tuberculosis of prostate——
A18.15 - Tuberculosis of other male genital organs——
A18.16 - Tuberculosis of cervix——
A18.17 - Tuberculous female pelvic inflammatory disease——
A18.18 - Tuberculosis of other female genital organs——
A18.2 - Tuberculous peripheral lymphadenopathy——
A18.3 - Tuberculosis of intestines, peritoneum and mesenteric glands——
A18.31 - Tuberculous peritonitis——
A18.32 - Tuberculous enteritis——
A18.39 - Retroperitoneal tuberculosis——
A18.4 - Tuberculosis of skin and subcutaneous tissue——
A18.5 - Tuberculosis of eye——
A18.50 - Tuberculosis of eye, unspecified——
A18.51 - Tuberculous episcleritis——
A18.52 - Tuberculous keratitis——
A18.53 - Tuberculous chorioretinitis——
A18.54 - Tuberculous iridocyclitis——
A18.59 - Other tuberculosis of eye——
A18.6 - Tuberculosis of (inner) (middle) ear——
A18.7 - Tuberculosis of adrenal glands——
A18.8 - Tuberculosis of other specified organs——
A18.81 - Tuberculosis of thyroid gland——
A18.82 - Tuberculosis of other endocrine glands——
A18.83 - Tuberculosis of digestive tract organs, not elsewhere classified——

References
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