Chromosomal Microarray, Postnatal

Last Modified: 2/2/2022 8:29:40 AM

Medical Necessity Documentation:  
Client Notes:

All insurance information must be filled out on the requisition

Pre-Authorization is required for this testing. 

Due to specimen stability, if Pre-Authorization is not with the patient at time of collection a recollect may need to be done once pre-authorization is obtained.

Patient Preparation:  
Specimen Requirements: 5.0 mL Whole Blood in two (2) Green Top Tubes - Na Heparin
Collection Instructions:  
Minimum Volume: 3.0 mL Whole Blood
Neonatal Volume: 2 full lavender microtainers - EDTA
Transport & Storage: Temperature/Stability:

When collected Monday thru Thursday - Ambient 
When collected Friday thru Sunday - Refrigerated

*Note Samples are best if received by Quest within 72 hours.

Unacceptable - Frozen

Rejection Criteria: Frozen; Specimen viability decreases during transit. Send specimen to testing lab for viability determination. Do not freeze. Do not reject.
Reference Range: Refer to Interpretive Results
Critical Ranges:  
Test Comments:

If results are not possible, the test order may be canceled and replaced by code 416-Cytogenetics Communication

Methodology: Oligo-SNP Array
Clinical Significance:

Determine genetic cause of developmental delay (DD) or mental retardation (MR) in patients with or without dysmorphic features.

Confirm, exclude, (or clarify) the diagnosis of known chromosomal syndromes.

Assist in clinical management and genetic counseling.

High resolution detection of chromosome segments involved in deletions, duplications, and long continuous stretches of homozygosity.

Custom Panel: No


Turn Around Time: 10 to 12 days
Days Performed: Sunday, Monday, Tuesday, Wednesday, Thursday, Friday
Sites Performed: Quest - Chantilly
PHL Test Code: CHRMP
EPIC Test Code: IMO5577
Send Out Test Code: 16478
Alternate Test Names: Array Genomic Alterations; Autism Genomic Alterations; Birth Defects Genomic Alterations; Chromosomal Microarray, Postnatal, ClariSure® Olig; ClariSure Oligo-SNP; ClariSure® Genomic Alterations; ClariSure® Oligo-SNP Array; Congenital Malformations; Constitutional Abnormality; Developmental Delay; Mental Retardation; Microarray Genomic Alterations; Oligo-SNP Array Genomic Alteration; Oligo-SNP Microarray; Postnatal; Subtelomere
Included Tests:  
CPT Coding: 81229

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