AlloMap

Alphabetical Test listing

AlloMap-8300

Test name:

AlloMap

Test number:

8300

Excellian order number:

LAB8300

Abbreviation:

ALM

Limitations:

Available for heart transplant patients at Abbott Northwestern (ANW) Hospital only

Patient preparation information:

Available for heart transplant patients at Abbott Northwestern Hospital only

Collection container:

Specialty tube:

CPT Cell preparation tube with Sodium Citrate

Volume:

8 mL

Minimum volume:

6 mL

Collection instructions:

Collect samples Mo - Fr from 6am - 1 pm
Immediately following collection, invert the tube 10 times; do not shake

Processing instructions:

To be performed by trained staff at the Central Lab only:

AlloMap processing checklist

Required forms/information:

HeartCare test requisition form
Molecular Medicare billing request
- 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

Transport and stability:

Frozen (-15°C or colder)

Performing lab:

XDX Expression Diagnostics: R-NX

Reference ranges:

See report

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:

81595

Subject to medical necessity (Y/N):

Yes

LCD/NCD:

Medical necessity

Date created:

04/02/2010

Revised date:

03/22/2022

Review date:

03/22/2022