FSHD (FSHD1,FSHD2) Detect, Abnormal Allele with Interpretation

Test Code
11171


CPT Codes
81404<br>Restricted Client Code

Preferred Specimen
18 mL whole blood: 6 mL whole blood collected in three separate K2 EDTA (pink-top) tubes


Minimum Volume
15 mL whole blood in 3 pink top tubes


Instructions
Do not centrifuge.
Label transport tube with two patient identifiers, date and time of collection.

Patient's age and sex is required on requisition for processing. Relevant clinical information must be submitted with specimen in order to provide correct interpretation of test results.
Submit whole blood in original container.

Transport Instructions:
To reduce the chance of delay, ship specimens on the same day of collection. Avoid shipping over any holidays and weekends. Ship at refrigerated temperature in a Styrofoam container.
Ship first overnight, collect Monday, Tuesday and Wednesday.
Prevent freezing of the specimen by insulating the specimen tube with bubble wrap, paper towels or cardboard to prevent contact with the coolant in the container. A frozen specimen cannot be used for testing. Place packing list into outside pocket of bag. Specimens are time sensitive. Best practice is to have specimens sent directly to UIDL as specimen begins to degrade immediately after collection Client will need to use the direct ship process to UIDL.


Transport Temperature
Refrigerated (cold packs)


Specimen Stability
Room temperature: 24 hours
Refrigerated: 5 days
Frozen: Unacceptable


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Frozen specimens, extracted DNA and blood specimens collected more than 5 days before receipt by the laboratory


Methodology
Optical Mapping • Southern Blot • DNA Sequencing

Setup Schedule
Set up: Weekly; Report available: 14 days for routine FSHD1 testing or subsets of FSHD2 testing; at least 4 weeks for complete FSHD1 and FSHD2 testing




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.