Laboratory Test Directory

Patient Preparation: Patient clinical information is helpful when interpreting test results. Test may review germline genetic changes. Please submit the “Genomic SNP Microarray Patient Clinical Information” and the “Informed Consent for Whole Genome SNP Microarray Testing” forms with the patient sample.

Collect: Use only unfixed material. For specimens not listed below, please contact the Molecular Diagnostics Laboratory to determine if they are acceptable for this test.

Peripheral Blood: 5-10 mL (minimum 5 x 10⁶ cell yield) in a sodium heparin (green-top_ tube is preferred. Yellow-top (ACD) and lavender-top (EDTA) tubes are accepted.

Bone Marrow Aspirate: If aspiration syringe requires internal pre-coating to prevent clotting, diluted sodium heparin (green-top_ tube should be utilized. Do not submit aspirates in syringes. Minimum volume is 2-3 mL (5-20 x 10⁶cells) in green-top tubes. ACD and EDTA tubes are accepted.

Specimen Preparation: No processing. Need to have a minimum of 20% tumor cells in the specimen to detect somatic changes.

Storage/Transport: Ambient or refrigerated. Do not freeze

Stability: Ambient: 48 hours; Refrigerated: 72 hours

Causes for Rejection: Incomplete and/or incorrect sample identification, frozen samples, incorrect collection container.

Clinical Information:

Patient clinical information is helpful to interpret test result. Please submit the “Genomic SNP Microarray Patient Clinical Information and the

“Informed Consent for Whole Genome SNP Microarray Testing”forms with

patient samples

Reference Range:

See report

Note:

The purpose of the SNP microarray test is to look for the presence of copy number variation (CNV) and loss of Heterozygosity” (LOH), throughout the entire genomic DNA. SNP array testing may have oncological applications. Chronic lymphocytic leukemia (CLL) and myelodysplastic syndromes (MDS) are especially suitable for SNP microarray analysis because of the high incidence of dosage-related clonal changes that have been demonstrated to have an impact on patient outcomes.

CPT 4 Code:

81406

Review

T. Friloux and Dr. Dong 6/4/2013

When ordering tests for which Medicare or Medicaid reimbursement will be sought, physicians should only order tests that are medically necessary for the diagnosis or treatment of the patient. Components of the organ or disease panels may be ordered individually. The diagnostic information must substantiate all tests ordered and must be in the form of an ICD-9 code or its verbal equivalent.

©Copyright 2011 UTMB Health, Pathology Clinical Services. Please Review Our Site Policies & Required Links.
301 University Boulevard, Galveston, Texas, 77555-0743 • UTMB Maps & Directions

Member, Texas Medical Center®