HSP, Common Dominant Evaluation

Test Code

93078

CPT Codes
81405 (x2), 81406 (x2), 81479 CPT coding may differ dependent on payer rules which may impact prior authorization testing. Please direct any questions regarding CPT coding to the payer being billed. This test is not available for New York patient testing Limited Access Code

Physician Attestation of Informed Consent

This germline genetic test requires physician attestation that patient consent has been received if ordering medical facility is located in AK, DE, FL, GA, IA, MA, MN, NV, NJ, NY, OR, SD or VT or test is performed in MA.

Preferred Specimen

8 mL whole blood collected in two EDTA (lavender-top) tubes
Pediatric (0-3 Years): 2 mL

Minimum Volume

6 mL • Pediatric: 1 mL

Transport Temperature

Room temperature

Specimen Stability

Room temperature: 10 days
Refrigerated: 10 days
Frozen: Unacceptable

Methodology
Next Generation Sequencing

Setup Schedule

Set up: Varies; Report available: 28-42 days

Reference Range

See Laboratory Report

Clinical Significance

This test includes sequencing 4 genes including: ATL1, SPAST, REEP1, KIF5A, and a SPAST deletion test. This test will detect 70-80% of genetic causes of autosomal dominant HSP.

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.