Specimen type:  

EDTA whole blood

Collection container:  

Lavender (EDTA), 4mL

Volume:  

3.0 mL

Minimum volume:  

1.0 mL

Collection instructions:  

Immediately following collection, mix sample by inverting 8 - 10 times to prevent clotting.

Processing instructions:  

Submit unspun

Alternate specimen type:  

ACD whole blood
Sodium citrate (Na cit) whole blood
Bone marrow in EDTA

Alternate collection container:  

 Yellow ACD (A or B)

 

Lt blue Sodium citrate (Na Cit) - 2.7mL 

Bone marrow - collected in EDTA 

Alternate specimen volume:  

3.0 mL

Alternate transport container:  

 Yellow ACD (A or B)

 

Lt blue Sodium citrate (Na Cit) - 2.7mL 

Bone marrow - collected in EDTA 

Transport and stability:  

Refrigerated (preferred) - 7 days

Ambient - 4 days

Do not freeze

Specimen retention time:  

14 days

Reason for rejection:  

• Heparin collection
• Frozen specimens

Performing lab:  

AHL - Molecular Diagnostics: D

Days set up:  

Varies

TAT:  

6 - 14 days

Method:  

Next Generation Sequencing

Clinical information:  

One of the customized panels can be selected below including any single gene add ons in the following tables.

Customized panel	Genes included
AML Therapeutic	FLT3, IDH1, IDH2, TP53
AML/MDS/Myeloid - Limited Panel	TP53, FLT3, NPM1, CEBPA, IDH1, IDH2, RUNX1, KIT, DNMT3A, KRAS, NRAS, ASXL1
Myeloproliferative Neoplasm NOS	BCR/ABL, JAK2, CALR, MPL
Myeloproliferative Neoplasm, not CML	JAK2, CALR, MPL
Myeloproliferative Neoplasm, suspicious for PV	JAK2
Myeloid full DNA and RNA panels	See below
Myeloid full DNA panel only	See below
Custom Panel	Choose specific genes below

 

*Individual genes can be selected in addtion to the panels listed above

DNA Panel: Hotspot Genes			DNA Panel: Full Genes			RNA Panel: fusion driver genes
ANKRD26	KRAS		ASXL1	PRPF8		ABL1	KAT6A (MOZ)	NUP214
ABL1	MPL		BCOR	RB1		ABL2	KAT6B	PAX5
BRAF	MYD88		CALR	RUNX1		BCL2	KMT2A	PDGFRA
CBL	NPM1		CEBPA	SH2B3		BRAF	KMT2A PTDs	PDGFRB
CSF3R	NRAS		ETV6	STAG2		CCND1	MECOM	RARA
DDX41	PPM1D		EZH2	TET2		CREBBP	MET	RUNX1
DNMT3A	PTPN11		IKZF1	TP53		EGFR	MLLT10	TCF3
FLT3 (ITD, TKD)	SMC1A		NF1	ZRSR2		ETV6	MRTFA(MKL1)	TFE3
GATA2	SMC3		PHF6			FGFR1	MYBL1	ZNF384
HRAS	SETBP1					FGFR2	MYH11
IDH1	SF3B1					FUS	NTRK2
IDH2	SRSF2					HMGA2	NTRK3
JAK2	U2AF1					JAK2	NUP98
KIT	WT1

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:  

AML Therapeutic: 81245, 81246, 81120, 81121, 81352
AML/MDS/Myeloid - Limited Panel: 81450
Myeloproliferative Neoplasm NOS: 81450
Myeloproliferative Neoplasm, not CML: 81279, 81219, 81338
Myeloproliferative Neoplasm, suspicious for PV: 81279
DNA Panel: Hotspot Genes: 81450
DNA Panel: Full Genes: 81450
RNA Panel: fusion driver genes: 81450
MYELOID NGS JAK2 EXON 12-15: 81279
MYELOID NGS CALR: 81219
MYELOID NGS MPL: 81338
MYELOID NGS IDH1: 81120
MYELOID NGS IDH2: 81121
MYELOID NGS SF3B1:81347
MYELOID NGS MYD88: 81305
MYELOID NGS BRAF: 81210
MYELOID NGS KIT: 81272
MYELOID NGS TP53: 81352
MYELOID NGS FLT3 ITD: 81245
MYELOID NGS FLT3 TKD: 81246
MYELOID NGS JAK2 V617F: 81270
MYELOID NGS NPM1: 81310
MYELOID NGS CEBPA: 81218
MYELOID NGS RARA: 81315
MYELOID NGS BCR/ABL: 81206
MYELOID NGS KRAS CODONS 12 AND 13: 81275
MYELOID NGS KRAS CODONS 61 AND 146: 81276
MYELOID NGS NRAS: 81311

Codes listed are associated with most common orders and is not inclusive of all potential orders

Subject to medical necessity (Y/N):  

Yes

Other billing information:  

Medical necessity

Hospital clients submitting a request for this assay on an outpatient with Medicare should complete and submit a Molecular Medical billing request form along with the sample.

• Complete and submit the form to notify us of the need for Allina Health Laboratory to bill insurance for Molecular testing performed
• All information requested is required in order for your request to be completed

Molecular Medicare billing request

Date created:  

11/21/2023

Review date:  

01/15/2024