Spreadsheet: ec63c94e-ef1f-40d9-932d-90bde3a23f85
Sheet: Sheet1

Test Referenced | Entry Type | Mayo ID | Description | Reporting Description | Method | Collection Container | Temperature | Stability | [NAME] | Unit of Measure | [NAME] | Minimum Volume | Reject Due To | Reference Values | Days/Times Performed | Analytic Time | Maximum Lab Time | CPT Units | CPT Code | LOINC® Code | LOINC® Attributes | Always Performed | Orderable Separately | Performing Location
CHRGB | Test | CHRGB | Chimerism-Recipient Germline (Pre) | Chimerism-Recipient Germline | Polymerase Chain Reaction (PCR) Amplification/Capillary Electrophoresis  (PCR is utilized pursuant to a license agreement with Roche Molecular Systems, Inc.) | Varies: Var |  |  |  | Varies | Forms:  1. Chimerism Analysis Information Sheet (Supply T594) in Special Instructions. 2. If not ordering electronically, submit a Hematopathology/Molecular Oncology Request Form (Supply T241) with the specimen.   The following information is required: 1. Pertinent clinical history 2. Specimen source 3. Donor identifier and donor date of birth 4. Donor date of collection   [NAME] must arrive within 168 hours of collection.   Submit only 1 of the following specimens:   Specimen Type: Blood Container/Tube: Preferred: Lavender top (EDTA) Acceptable: ACD	 [NAME]: 6 mL Collection Instructions:  1. Invert several times to mix blood. 2. Send specimen in original tube. 3. Label specimen as blood.  	 [NAME] marrow Container/Tube: Preferred: Lavender top (EDTA) Acceptable: ACD	 [NAME]: 2 mL Collection Instructions: 1. Invert several times to mix bone marrow. 2. Send specimen in original tube. 3. Label specimen as bone marrow.   [NAME] swab Container/Tube: Buccal Smear Collection Kit (Supply T543) [NAME]: 2 Cyto-Pak brushes-1 per cheek Collection Instructions: 1. Patient should rinse out mouth vigorously with mouthwash for approximately 15 seconds. 2. [NAME] brush from container only touching "stick" end. Save container. 3. Using medium pressure, rotate brush several times on inside of cheek. 4. Return brush to container and cap. 5. Repeat steps 2 through 4 on other cheek using second brush. 6. It is important that patient's buccal cells are not contaminated with cells from any other source. Do not touch bristles. Do not brush too vigorously. If blood appears, discard brush. Restart collection process. 7. Label each container with patient's name and order number or hospital/clinic number. Additional Information: It is important that the cells do not dry out during shipping. Ensure that container is tightly sealed. | Blood: 3 mL/Bone Marrow: 2 mL/Le | Hemolysis	Mild OK; Gross reject Thawing	NA Lipemia	NA Icterus	NA Other	NA | An interpretive report will be provided. | Monday through Friday; 9 a.m. | 4 days | 8 days | 1 | 81265 |  |  |  |  | Rochester
CHRGB | [NAME] | VARIES | Varies |  |  |  | Ambient | 7 days
CHRGB | Order Question | MP007 | Donor |  | Plain Text
CHRGB | Order Question | MP014 | [NAME] |  | Answer List
CHRGB | Option | MP014-1 | Buccal Swab
CHRGB | Option | MP014-2 | EDTA blood
CHRGB | Option | MP014-3 | EDTA bone marrow
CHRGB | Option | MP014-4 | Extracted DNA
CHRGB | Result | MP007 | Donor | Donor | Alphanumeric
CHRGB | Result | MP014 | [NAME] | [NAME] | Alphanumeric
CHRGB | Result | 83186 | Chimerism-Recipient Germline | Chimerism-Recipient Germline | Alphanumeric