Last Modified:
10/21/2021 3:20:51 PM
Medical Necessity Documentation:
Client Notes:
Patient Preparation:
Specimen Requirements:
5.0 mL Whole Blood in an Lavender Top Tube
Collection Instructions:
Requisition form and Pathology/Flow Cytometry Reports are required
Minimum Volume:
2.0 mL Whole Blood
Transport & Storage: Temperature/Stability:
5.0 mL (2.0) Bone Marrow in an Lavender Top Tube - EDTA in a plastic vial
or
5.0 mL (2.0) Whole Blood in an Green Top Tube - Na Heparin in a plastic Vial
7 days Ambient, 7 days Refrigerated, Unacceptable Frozen
or
5.0 mL (2.0) Bone Marrow in an Green Top Tube - Na Heparin in a plastic Vial
7 days Ambient, 7 days Refrigerated, Unacceptable Frozen
or
50 uL of 10 ng/uL extracted DNA in microcentrifuge tube, only accept extracted DNA when extraction or isolation is performed in an appropriately qualified laboratory such as a CLIA certified laboratory or a laboratory meeting equivalent requirements as determined by the CAP and/or CMS.
Extracted DNA Room temperature: 30 days Refrigerated: 2 years Frozen: Indefinite
or
Celle pellet Fixed pellet collected in a sterile leak-proof container
Celle pellet Room temperature: 7 days Refrigerated: 7 days Frozen: Unacceptable
Rejection Criteria:
Gross hemolysis • Frozen • Clotted
Reference Range:
Please refer to Interpretive Report
Critical Ranges:
Test Comments:
Methodology:
Next Generation Sequencing
Clinical Significance:
This test is designed to aid in diagnosis, prognosis and/or treatment strategy for patients with MPN
Documentation:
Custom Panel:
No
PRODUCTION SCHEDULE
Turn Around Time:
11 to 15 days
Days Performed:
Tuesday, Thursday
Sites Performed:
Quest - Chantilly to San Juan Capistrano
PHL Test Code:
MSOT
EPIC Test Code:
MISC
Send Out Test Code:
36788
Alternate Test Names:
LeukoVantage®, Myeloproliferative Neoplasms (MPN); MPN; Myeloid NGS Panel MPN
Included Tests:
ASXL1; BRAF; CALR; CBL; CSF3R; ETNK1; ETV6; EZH2; HRAS; IDH1; IDH2; IKZF1; JAK2; KIT; KRAS; MPL; NF1; NRAS; PTEN; PTPN11; SETBP1; SF3B1; SRSF2; TET2; TP53; U2AF1 genes
CPT Coding:
81450
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