MGMT promoter methylation, tumor-Pathology add-on

Test info

  
MGMT promoter methylation, tumor
  
Pathology add-on
  

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

  
Tissue
  

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.

  

Submit processed tissue block

  

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

  

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

  

Molecular Medicare Billing Request

Hospital clients submitting a request for this assay on an outpatient with Medicare should complete and submit a Molecular Medicare billing request form to notify us of the need for Allina Health Laboratory to bill insurance.

  

Ambient (preferred)

Frozen

Refrigerated

Performance

  
Mayo Clinic Laboratories (MGMT): R
  
Weekly; varies
  
7 - 10 days
  

Methylation-specific Polymerase Chain Reaction (PCR) analysis

Clinical and Interpretive info

  

An interpretive report will be provided.

Billing

  
This test may require preauthorization from the insurance provider. Check the payer guidelines and, if needed, obtain the pre-authorization prior to sample collection.
  
81287 - slide review
88381
  
Yes
  

Medical necessity

Hospital clients submitting a request for this assay on an outpatient with Medicare should complete and submit a Molecular Medicare billing request form to notify us of the need for Allina Health Laboratory to bill insurance.

Molecular Medicare Billing Request

Tracking

  
06/15/2018
  
05/23/2024
  
06/23/2023