June 2025

Discoveries, trends, and discussions in medical diagnostics

Welcome to the June issue of Diagnostics Dialogue, where you can get up to speed on the most important discoveries, trends, and discussions in medical diagnostics. Continue reading to learn more.

June 27 is National HIV testing day  

June 27 is National HIV testing day  

June 27 is National HIV testing day  

June 27 is National HIV testing day  

Each year in the US, National HIV testing day is observed on June 27 to raise awareness about the importance of testing for HIV and getting an early diagnosis.

HIV remains a persistent problem in the US:

The CDC recommends2:

Everyone between the ages of 13 and 64 should get tested for HIV at least once

People with certain risk factors should get tested more often

With assays for all stages of the HIV patient journey, Quest can help you support your patients throughout their care continuum, from prevention and screening to monitoring treatments.

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Better outcomes

Better outcomes

Detect dangerous NPS combinations with confidence

Novel psychoactive substances (NPS) are on the rise, including xylazine and fentanyl analogs—which are frequently found in specimens and are contributing to the nation’s misuse crisis.3
NPS can be more potent and harder to detect than traditional drugs of abuse6,7
As new compounds continually appear, detecting them via presumptive immunoassay or point-of-care testing can be challenging.

Can be present in counterfeit drugs

Can cause more severe drug-to-drug interactions

Are often found in combination with other substances

Are often consumed unknowingly
Quest offers the Drug Monitoring, NPS panel, a definitive drug test that simultaneously identifies the 6 major NPS classes:
  • Designer fentanyl analogs ie, carfentanil, chlorofentanyl
  • Xylazine and other illicit additives ie, tianeptine
  • Designer benzodiazepines ie, BZS, clonazolam
  • Designer opioids ie, nitazenes
  • Designer stimulants ie, fluorexetamine
  • Synthetic cannabinoids ie, ADB-5Br-PINACA

Give patients the power of prevention with PrEP

Pre-exposure prophylactic (PrEP) medications could benefit an estimated 1.2M people in the US, but fewer than 36% of them are taking such prescriptions.8

PrEP could help reduce the risk of getting HIV in the following ways
From sex about 99%(9) | From injection drug use by at least 74%(9)
Who is eligible for PrEP therapy?
Updated CDC guidance states that all sexually active adults and adolescents, and/or persons who inject drugs, should receive information about PrEP and its role in reducing the risk of acquiring HIV.10

PrEP is particularly recommended for patients who report behaviors or circumstances that place them at substantial risk of exposure and infection, including10:
  • HIV-positive sexual or injection partner
  • Bacterial sexually transmitted infection in the past 6 months
  • History of inconsistent or no condom use with sexual partner(s)
Quest offers flexible, reliable testing for PrEP that includes the most recent CDC guideline-recommended tests to determine clinical eligibility and to monitor patients while on PrEP.

Flexible testing options so you can choose the right test based on your patient’s unique requirements

Billing and reimbursement challenges mitigated by our updated menu offering

Gender-inclusive testing language designed to cater to all your patients, regardless of gender

Accessible testing options with 2,400 Patient Service Centers and in-office phlebotomists to help patients get the tests they need when they need them

Make timely tick-borne disease diagnoses

The annual number of tick-borne disease cases has more than doubled in the US in the past 2 decades.11

In many cases, coinfection with multiple tick-borne diseases is common
  • 50% of patients suffering from post-treatment Lyme disease had coinfections15
  • 30% had 3 or more simultaneous infections15
Lyme disease, the most common tick-borne disease, affects ~476K Americans each year12,13
CDC guidelines recommend lab testing to confirm diagnosis of tick-borne diseases.16

Depending on the patient’s initial exposure, onset, and presence of symptoms, Quest offers more than 30 tick-borne disease tests and panels to help make an informed diagnosis and initiate the right treatment, which could lead to better outcomes for your patients. 

Better experiences

Better experiences

Understand the gut-health connection

70%-80% of the immune system is in the gut,17 and gut health is interconnected with a variety of acute and chronic conditions.
From screening and diagnosis to treatment and monitoring, Quest offers a vast gastroenterology testing portfolio that provides reliable answers from a single source.

Test the right patients to help stem the rising tide of TB

TB cases in the US continue to rise.22 While anyone can get TB, the USPSTF recommends screening for latent TB infection in populations at increased risk.23
The CDC also recommends testing patients with diabetes, HIV, cancer, and other conditions26

>23% of TB cases occurred in people with diabetes22

>4% of people with TB are coinfected with HIV27

It’s 9x more likely for people with certain cancers to develop active TB compared to those without cancer28
Blood-based IGRA testing is the preferred testing method for TB and Quest is the only national commercial reference lab to offer a choice of TB blood tests.

Removing traditional barriers to testing 

Removing traditional barriers to testing 

Removing traditional barriers to testing 

HbA1c testing is covered by Medicare to help improve diabetes screening

Nearly 30M people in the US have a diabetes diagnosis.29 But an additional 9M people are living with the disease—and don’t know it.29 
Early detection is essential to improving outcomes
The Centers for Medicare and Medicaid Services (CMS) recognize hemoglobin A1c (HbA1c) testing (CPT® 83036)a as a covered diabetes screening test using ICD code Z13.1 for Medicare and Medicare Advantage patients.

If you determine that patients are at risk for diabetes,b they may be eligible for HbA1c or blood glucose lab test screenings twice every year.30 Medicare Part B covers these screenings if your patient has:

Hypertension

Dyslipidemia

Obesity

History of hyperglycemia
These screenings are also covered if your patient:
  • Is 65 years of age or older
  • Is overweight
  • Has parents or siblings with a history of diabetes
  • Has a history of gestational diabetes or delivered a baby weighing more than 9 lbs
a The CPT® codes provided are based on American Medical Association guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
b Diagnoses must always be documented in the patient’s medical record. The ultimate responsibility belongs to the ordering physician to correctly assign the patient’s diagnosis based on the patient’s history, symptoms, and medical condition.

Achieving the Quadruple Aim in your practice

Our purpose is to support you and your patients with leading services, patient experiences, and innovative testing that can help you provide clarity to the constant changes and challenges we’re seeing in healthcare today.

About Diagnostics Dialogue

In our conversations with providers across the country, we hear that you are facing many different constraints that make delivering care challenging. We’re here to help you navigate the uncertainty and deliver better health. With a broad test menu spanning 3,500+ tests and consultations from our medical staff of over 850 MDs and PhDs, we empower healthcare providers to create healthier communities, one patient at a time.
References
  1. HIV.gov. US statistics. February 21, 2025. Accessed May 5, 2025. https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics
  2. CDC. Getting tested for HIV. February 11, 2025. https://www.cdc.gov/hiv/testing/index.html
  3. Quest Diagnostics Health Trends. Drug misuse in America 2023: the growing crisis of novel psychoactive substances. December 23, 2024. Accessed February 12, 2024. https://mma.prnewswire.com/media/2303443/Quest_Diagnostics_2023_HT_DM_Report.pdf?p=original
  4. Quest Diagnostics NPS report, 2025.
  5. Kariisa M, O’Donnell J, Kumar S, et al. Illicitly manufactured fentanyl–involved overdose deaths with detected xylazine— US, January 2019–June 2022. MMWR Morb Mortal Wkly Rep 2023;72:721-727. doi:10.15585/mmwr.mm7226a4
  6. Iwersen-Bergmann S, Lehmann S, Heinemann A, et al. Mass poisoning with NPS: 2C-E and Bromo-DragonFly. Int J Legal Med. 2019;133(1):123-129. doi:10.1007/s00414-018-1882-9
  7. Peacock A, Bruno R, Gisev N, et al. New psychoactive substances: challenges for drug surveillance, control, and public health responses. Lancet. 2019;394(10209):1668-1684. doi:10.1016/s0140-6736(19)32231-7
  8. Office of Infectious Disease and HIV/AIDS Policy, HHS. Ready, Set, PrEP. HIV.gov. Updated March 18, 2022. Accessed October 5, 2023. https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/prep-program/
  9. CDC. Pre-Exposure Prophylaxis (PrEP). Updated July 5, 2022. Accessed October 5, 2023. https://www.cdc.gov/hiv/risk/prep/index.html
  10. US Public Health Service, CDC. Preexposure prophylaxis for the prevention of HIV infection in the United States – 2021 update – a clinical practice guideline. Accessed October 5, 2023. https://www.cdc.gov/hiv/pdf/risk/prep/cdc-hiv-prep-guidelines-2021.pdf
  11. Winny A. Tickborne diseases are on the rise—here’s what to know. Johns Hopkins. June 21, 2023. Accessed March 19, 2024. https://publichealth.jhu.edu/2023/lyme-disease-isnt-the-only-tickborne-disease-to-watch
  12. Schwartz AM, Kugeler KJ, Nelson CA, et al. Use of commercial claims data for evaluating trends in Lyme disease diagnoses, United States, 2010-2018. Emerg Infect Dis. 2021;27(2):499-507. doi:10.3201/eid2702.202728
  13. Kugeler KJ, Schwartz AM, Delorey M, et al. Estimating the frequency of Lyme disease diagnoses—United States, 2010-2018. Emerg Infect Dis. 2021;27(2):616-619. doi:10.3201/eid2702.202731
  14. US Dept of Health and Human Services. Tick-borne disease working group—2018 report to Congress. August 10, 2017. Accessed March 19, 2024. https://www.hhs.gov/sites/default/files/tbdwg-report-to-congress-2018.pdf
  15. Johnson L, Wilcox S, Mankoff J, et al. Severity of chronic Lyme disease compared to other chronic conditions: a quality of life survey. PeerJ. 2014;2:e322. doi:10.7717/peerj.322
  16. CDC. Testing and diagnosis for Lyme disease. Accessed February 14, 2025. https://www.cdc.gov/lyme/diagnosis-testing/index.html
  17. Wiertsema SP, van Bergenhenegouwen J, Garssen J, et al. The interplay between the gut microbiome and the immune system in the context of infectious diseases throughout life and the role of nutrition in optimizing treatment strategies. Nutrients. 2021;13(3):886. doi:10.3390/nu13030886
  18. Ni J, Wu G, Albenberg L, et al. Gut microbiota and IBD: causation or correlation?. Nat Rev Gastroenterol Hepatol. 2017;14(10):573-584. doi:10.1038/nrgastro.2017.88
  19. Glassner KL, Abraham BP, Quigley EMM. The microbiome and inflammatory bowel disease. J Allergy Clin Immunol. 2020;145:16-27. doi:10.1016/j.jaci.2019.11.003
  20. Shane AL, Mody RK, Crump JA, et al. 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea. Clin Infect Dis. 2017;65(12):1963-1973. doi:10.1093/cid/cix669
  21. Neag MA, Mitre AO, Catinean A, Buzoianu AD. Overview of the microbiota in the gut-liver axis in viral B and C hepatitis. World J Gastroenterol. 2021;27(43):7446-7461. doi:10.3748/wjg.v27.i43.7446 5
  22. CDC. Reported tuberculosis in the US, 2023. About the data. November 5, 2024. Accessed March 19, 2025. https://www.cdc.gov/tb-surveillance-report-2023/summary/index.html
  23. US Preventive Services Task Force. Screening for latent tuberculosis infection in adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2023;329(17):1487-1494. doi:10.1001/jama.2023.4899
  24. CDC. Health disparities in tuberculosis. January 31, 2025. Accessed March 19, 2025. https://www.cdc.gov/tb/health-equity/index.html
  25. CDC. TB risk and people experiencing homelessness. October 30, 2024. Accessed March 19, 2025. https://www.cdc.gov/tb/risk-factors/homelessness.html
  26. CDC. Testing for tuberculosis. June 17, 2024. Accessed April 8, 2024. https://www.cdc.gov/tb/testing/index.html
  27. CDC. Reported tuberculosis in the US, 2022. Updated November 15, 2023. Accessed June 25, 2024. https://www.cdc.gov/tb/statistics/reports/2022/table17.htm
  28. Cheng MP, Abou Chakra CN, Yansouni CP, et al. Risk of active tuberculosis in patients with cancer: A systematic review and meta-analysis. Clin Infect Dis. 2017;64(5):635-644. doi:10.1093/cid/ciw838
  29. CDC. National diabetes statistics report. Updated May 15, 2027. Accessed May 28, 2025. https://www.cdc.gov/diabetes/php/data-research/index.html
  30. Centers for Medicare and Medicaid Services (CMS). Your Medicare coverage: diabetes screening. Accessed December 12, 2023. https://www.medicare.gov/coverage/diabetes-screenings
The CPT® codes provided are based on American Medical Association guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Image content features models and is intended for illustrative purposes only.
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