Test

CPT

 

Specimen requirements

(Samples for constitutional/germline genetic testing must be received in the original sample collection tube.)

Amniotic Fluid, Routine

88235 
88267 
88280 
88291

10-15 mL amniotic fluid, unspun, in two 15mL centrifuge tubes (Corning, Falcon, or equivalent). Discard the first 3 mLs drawn, do not centrifuge. Label all tubes with patient name and date of birth. Store and transport at room temperature. Minimum acceptable volume is 5 mLs: if additional tests such as prenatal interphaseFISH is ordered, 15-20mL is required.

Amniotic Fluid, Tissue 
Culture only

88235

10-15mL amniotic fluid, unspun, in two 15 mL centrifuge tubes (Corning, Falcon, or equivalent). Discard the first 3 mLs drawn, do not centrifuge. Label all tubes with patient name and date of birth. Store and transport at room temperature.

Peripheral Blood, Routine

88230
88262
88280
88291

5 mL sodium heparinized whole blood (green-top tube). Label all tubes with patient name and date of birth. Store and transport at room temperature. Minimum acceptable volume is: 0.5-1 mL (newborns only), 1 mL (children and adults), 10-15 mL in EDTA (if Fragile X molecular testing is ordered also).

Chromosome Microarray

 (Constitutional)

81229

Minimum 1 mL sodium heparinized whole blood (green-top tube),10-15 mL amniotic fluid, or one or more 5 mm tissue biopsy, in sterile container containing media with antibiotics or other sterile isotonic solution (media is preferred) from tissue such as products of conception. Label all tubes with patient name and date of birth. Store and transport at room temperature. Please contact the laboratory for specific information or click HERE for the reflex forms and other information.

Peripheral Blood, Mosaicism

88230
88261
88263
88285
88291

5 mL sodium heparinized whole blood (green-top tube). Label all tubes with patient name and date of birth. Store and transport at room temperature. Minimum acceptable volume is: 1 mL (newborns only), 2 mL (children and adults): please include 10-15 mL in EDTA (if Fragile X molecular testing is ordered also).

Peripheral Blood, 
Family Study

88230
88261
88291

5 mL sodium heparinized whole blood (green-top tube). Label all tubes with patient name and date of birth. Store and transport at room temperature. Minimum acceptable volume is: 1 mL.

Products of Conception
and Solid Tissue, 
Routine

88233
88262
88280
88291

One or more 5 mm tissue biopsy, in sterile container containing media with antibiotics or other sterile isotonic solution; media is preferred. Label all tubes or transport container with patient name and date of birth. Store and transport at room temperature. Preferred tissues include placenta (fetal side containing chorionic vili), skin, and/or other internal organs. Tendon and other fibrous tissues are less likely to yield results.

Solid Tissue, 
Mosaicism Study

88233
88261
88263
88285
88291

One or more 5 mm skin biopsy, full thickness punch, in sterile container containing media with antiobiotics or other isotonic solution. Label all tubes with pationt name and date of birth.

Solid Tissue, 
Tissue culture only, 
for send-out testing

88230

One or more 5 mm skin biopsy, full thickness punch, in sterile container containing media with antiobiotics or other isotonic solution. Label all tubes with pationt name and date of birth.

Bone Marrow or 
Leukemic Blood, Routine

88237
88264
88280 × 3
88291

Bone marrow aspirate or peripheral blood in either transport media (available from the laboratory) or sodium heparin. Label all tubes with patient name and date of birth. Store and transport at room temperature. Minimum acceptable volume is 0.5 mL.

Solid Tumor

88239
88264
88280 × 3
88291

Minimum of 1 cm tumor biopsy or material from FNA in cell culture transport media: transport kits containing appropriate media are available from the laboratory. Please include tumor biopsy site, suspected or differential diagnosis, and clinical history of patient.

 

Neoplastic SNP Microarray

 

 

 

 

FISH (fluorescent in situ hybridization)

 

81406 

 

DNA can be isolated from either bone marrow, leukemic blood or solid tumor samples (fresh) received for metaphase cytogenetic or FISH analysis for reflex to SNP microarray analysis.  Snap frozen solid tumor tissue can also be accepted for SNP microarray analysis only..  Click HERE for the reflex form.

 

Depends on combination of FISH probes ordered and whether a metaphase or interphase analysis is clinically indicated. Please contact the laboratory for specific information or click HERE for the reflex FISH forms and HERE for the list of currently validated probes.

Constitutional FISH 
Only (metaphase)

88230
88271 x (# 
  of probes)
88283
88291

5 mL sodium heparinized whole blood (green-top tube). Label all tubes with patient name and date of birth. Store and transport at room temperature. Minimum acceptable volume is: 1 mL.

Prenatal Interphase FISH

88291

88283x2

88275x2

88271x5

8 mL whole amniotic fluid in a sterile tube. Label all tubes with patient name and date of birth. Store and transport at room temperature.

FISH Glioma

88274
88365 × 2
88291

Formalin Fixed paraffin-embedded tumor tissue, along with an H and E slide. Please submit entire block, which will be returned after the testing is complete.

FISH HER2 (ERBB2)

 

 

88271x2
88274/88275
88283
88291 

Formalin Fixed paraffin-embedded tumor tissue, along with an H and E slide from the same block, with invasive component of breast cancer clearly indicated.

 

 

FISH Lymphoma

88271x9

88275x4

88283x4

88291

Formalin Fixed paraffin-embedded tumor tissue, along with H and E slide with tumor marked if there is not complete tissue involvement.  Probes to choose from include MYC,  BCL2/IGH, BCL6 and MYC/IGH.