Test Overview
Test Methodology

Nontreponemal flocculation procedure (RPR).

Test Usage

Neonatal evaluation for syphilis, with reflex titer.

Reference Range *

Non-reactive

* Reference ranges may change over time. Please refer to the original patient report when evaluating results.

Test Limitations

Nonspecific positive reactions may be found in SLE, malaria, infectious mononucleosis, hepatitis, leprosy, brucellosis, atypical pneumonia, typhus, and other infections. Reactive tests due to related treponemal infections (bejel, pinta, or yaws) may also occur. A reactive result in a newborn may be due to passive transfer from mother's blood.

Test Details
Days Set Up
M-F
Analytic Time

8 hours

Soft Order Code
RPRNB
MiChart Code
RPR (neonatal evaluation only, with reflex titer)
Laboratory
Chemical Pathology
Section
Immunopathology
Specimen Requirements
Collection Instructions

Collect specimen in SST tube. Centrifuge, aliquot serum into plastic vial and refrigerate.

Alternate Specimen
Red top tube.
Plasma, EDTA, heparin.
Contraindications
Contaminated, lipemic or grossly hemolyzed sera should not be used because of the possibility of nonspecific reactions.
Normal Volume
1.0 ml
Minimum Volume
0.5 ml
Rejection Criteria
CSF
Additional Information

Reactive specimens will be titered (RPRQN). The more specific TPPA test will not be performed In untreated syphilis, reactive sera are found in the chancre stage 30% after one week and 90% after three weeks. In the secondary stage, the RPR should be reactive 100% of the time, decreasing to 90% in the tertiary stage. In the latent stage and after successful treatment, the RPR may become nonreactive. The titer of antibody will vary from patient to patient. There is no direct relationship between the amount of reagin and the severity of disease. A patient's peak titer will usually occur during the secondary stage, then decrease and plateau during later stages. By ordering this test the clinician acknowledges that additional reflex testing will be performed and billed at a separate additional charge if indicated.

Billing
CPT Code
86592
Fee Code
21922
Reflex CPT
86593 Titer
Reflex Fee Code
21923 Titer
LOINC
20507-0 (RPR); 31147-2 (RPRQN)