What Is Part 3 of Form I-693 (Tuberculosis Testing)?
Quick Answer
Part 3 of Form I-693 documents the results of tuberculosis (TB) testing required for the immigration medical examination. The civil surgeon records the type of TB test administered (IGRA blood test or TST skin test), the test results, and any follow-up findings such as chest X-ray results or sputum culture results if required.
Why Is TB Testing Required for Immigration?
Tuberculosis is a communicable disease of public health significance under U.S. immigration law. USCIS requires all applicants for adjustment of status to be screened for TB as part of the immigration medical examination. The results are documented in Part 3 of Form I-693. Active TB disease is a ground of inadmissibility, while latent TB infection (LTBI) typically requires follow-up treatment but does not by itself prevent immigration.
IGRA vs. TST: Which Test Is Used?
USCIS-designated civil surgeons may use either the Interferon-Gamma Release Assay (IGRA) blood test — such as the QuantiFERON-TB Gold Plus — or the Tuberculin Skin Test (TST, also called the Mantoux test). The IGRA is generally preferred because it requires only one visit and is not affected by prior BCG vaccination. The TST requires a return visit 48–72 hours after placement to read the result. The civil surgeon documents which test was used and the specific result in Part 3.
What Happens If the TB Test Is Positive?
A positive TB test result triggers additional evaluation. The civil surgeon will order a chest X-ray to determine whether there is evidence of active TB disease. If the chest X-ray is abnormal, sputum cultures may be required to rule out active infectious TB. All of these results are documented in Part 3. A positive IGRA or TST alone — without evidence of active disease — typically indicates latent TB infection, which is not a ground of inadmissibility but may require a follow-up treatment plan.
Chest X-Ray Documentation in Part 3
When a chest X-ray is performed, the civil surgeon documents the radiologist's interpretation in Part 3. The findings are classified as normal, abnormal but not consistent with TB, or abnormal and consistent with TB. If the chest X-ray shows findings consistent with active TB, the civil surgeon cannot complete the form until the applicant has been evaluated by a TB specialist and the results are available. Pregnant applicants may have the chest X-ray deferred with appropriate shielding or until after delivery.
Sputum Culture Requirements
If the chest X-ray shows findings consistent with active pulmonary TB, the civil surgeon must obtain sputum specimens for acid-fast bacilli (AFB) smear and culture. Three sputum specimens collected on three separate days are typically required. The results of these cultures are documented in Part 3. The civil surgeon cannot certify the form as complete until sputum culture results are available and reviewed. This process can add several weeks to the overall timeline.
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