MGMT promoter methylation, tumor

Alphabetical Test listing

MGMT promoter methylation, tumor-Pathology add-on

Test name:

Test number:

Pathology add-on

Useful for:

Prognostication of newly diagnosed glioblastomas Identifying newly diagnosed glioblastomas that may respond to alkylating chemotherapy (ie, temozolomide) Guiding therapy decision making for newly diagnosed glioblastomas in elderly patients (>60 years)

Specimen type:

Tissue

Collection instructions:

At least 40% tumor is required for this assay. In general, a 6 mm x 3 mm area of tissue cut at 5 micron thickness is the minimum amount of tissue needed; this could be collected over multiple slides.

Processing instructions:

Submit processed tissue block

Transport container:

Formalin-fixed, paraffin-embedded (FFPE) tissue block

Alternate transport container:

One (1) slide stained with hematoxylin and eosin and five (5) unstained, non-baked 5-micron thick sections of the tumor

Transport and stability:

Ambient (preferred)

Frozen

Refrigerated

Performing lab:

Mayo Clinic Laboratories (MGMT): R

Days set up:

Weekly; varies

TAT:

7 - 10 days

Method:

Methylation-specific Polymerase Chain Reaction (PCR) analysis

Reference ranges:

An interpretive report will be provided.

Preauthorization:

This test may require preauthorization from the insurance provider. Check the payer guidelines and, if needed, obtain the pre-authorization prior to sample collection.

CPT codes:

81287 - slide review
88381

Subject to medical necessity (Y/N):

Yes

LCD/NCD:

Medical necessity

Date created:

06/15/2018

Revised date:

06/23/2023

Review date:

06/23/2023