KRAS and NRAS Mutation Analysis, Cell-based

Test Code
35799


CPT Codes
81311, 81275, 81276

Preferred Specimen
Formalin-fixed, paraffin-embedded tissue block


Minimum Volume
3 mL whole blood • 1 mL bone marrow aspirate • 4 unstained charged (+) slides


Other Acceptable Specimens
5 mL whole blood collected in an EDTA (lavender-top) tube or sodium heparin (green-top) tube  • 3 mL bone marrow aspirate submitted in an EDTA (lavender-top) tube or sodium heparin (green-top) tube • 8 unstained charged (+) slides


Instructions
Submission of formalin-fixed, paraffin-embedded tissue is the preferred sample type. Other sample types listed are acceptable for testing. For submission of paraffin block, another preferred specimen type, tissue source and block ID are required on the requisition form. A pathology report must be submitted.

Whole blood: Follow standard whole blood collection procedures. Collect 4-6 mLs whole blood in an EDTA tube. Record sample type, collection time and date onto tube and requisition form.

Bone marrow collection: The notation of sample type, collection time and date onto the tube and requisition form is required. Ship sample at refrigerated temperature or room temperature. Ship immediately to maintain stability.


Transport Temperature
Room temperature


Specimen Stability
Formalin-fixed paraffin embedded tissue/Slides
Room temperature: 5 years
Refrigerated: 5 years
Frozen: Unacceptable

Whole blood and bone marrow
Room temperature: 72 hours
Refrigerated: 72 hours
Frozen: Unacceptable


Methodology
Next Generation Sequencing

FDA Status
This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Setup Schedule
A.M.


Clinical Significance
Recent studies have shown that mutations in KRAS and NRAS exons 2, 3, and 4 have influence on response to anti-EGFR therapy. Testing these genes will aid in selection of patients who will likely respond to anti-EGFR therapy. KRAS, along with others, is a clinically actionable biomarker in NSCLC (non-small cell lung cancer) and other tumor types. Currently, in NSCLC the KRAS G12C mutation is prevalent in approximately 13% of patients and represents nearly half (44%) of all KRAS mutations. Investigational agents targeting KRAS G12C are currently in clinical trials.




The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.