New Syphilis testing which had been previously delayed (MLabs Test Updates 884 and 885) will be implemented effective December 10, 2024. The MLabs Immunology Laboratory will begin offering a reverse algorithm for syphilis screening as well as new order codes for monitoring treatment of patients with known syphilis and for neonatal testing.
For screening patients for syphilis, the algorithm starts with syphilis total antibodies (order code SYPH) and orderable name is Syphilis screening, reverse algorithm (syphilis total antibodies with reflexes). Reactive results will reflex to additional testing per the reverse algorithm, including Rapid Plasma Reagin (RPR) (fee code 21922 CPT 86592), RPR Titer (RPRQN) (fee code 21923 CPT 86593), and/or Syphilis Antibody, Treponema pallidum Particle Agglutination (TPPA) (fee code KA050 CPT 86780). Interpretive comments will be included with the reverse algorithm screening to help guide result interpretation.
For monitoring patients with known, previously diagnosed syphilis with RPR the order code is RPRM with orderable name RPR (monitoring for known syphilis only, with reflex titer). Positive results will reflex to RPR Titer (RPRQN). Note that Syphilis Antibody Treponema pallidum Particle Agglutination (TPPA) is not performed or indicated in patients with a known, documented history of syphilis.
For newborn syphilis screening the order code is RPRNB with orderable name RPR (neonatal evaluation only, with reflex titer). Reactive results will reflex to RPR Titer (RPRQN).
The following tests will be discontinued:
- Syphilis Antibody, Treponema pallidum Particle Agglutination and Rapid Plasma Reagin, order code TPRP will be discontinued.
- Syphilis Antibody, Treponema pallidum Particle Agglutination, order code TPPA will remain orderable for MLabs clients that perform screening at their facility.
- Syphilis Screening Test, RPR, Serum, will no longer be orderable individually, order code RPR will be used only for reflex testing.
- Syphilis IgG with Reflex (Mayo SYPH1), order code MMLR, will no longer be offered.
- Syphilis Total Antibody (Mayo NSYPH), order code NSYPH, will no longer be offered.