Spreadsheet: 84c77146-220a-4c48-babd-a334c8368cc6
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
FMDL | Test | FMDL | Miller-Dieker Syndrome, 17p13.3 Deletion, FISH | Miller-Dieker, 17p13.3 Del, FISH | Fluorescence In Situ Hybridization (FISH) | Varies: Var |  |  |  | Varies | Provide a reason for referral with each specimen. The laboratory will not reject testing if this information is not provided, but appropriate testing and interpretation may be compromised or delayed.   Forms: 1. New York Clients-Informed consent is required. Please document on the request form or electronic order that a copy is on file. An Informed Consent for Genetic Testing (Supply T576) is available in Special Instructions. 2. If not ordering electronically, submit a Cytogenetics/AFP Congenital Disorders Request Form (Supply T238) with the specimen.   Advise Express Mail or equivalent if not on courier service.   Submit only 1 of the following specimens:   Specimen Type: Amniotic fluid Container/Tube: Amniotic fluid container [NAME]: 20-25 mL Collection Instructions:  1. Optimal timing for specimen collection is during 14 to 18 weeks of gestation, but specimens collected at other weeks of gestation are also accepted. Provide gestational age at the time of amniocentesis. 2. Discard the first 2 mL of amniotic fluid. Specimen Stability Information: Refrigerated (preferred)/Ambient Additional Information:  1. Place the tubes in a [NAME] container (Supply T329). 2. Fill remaining space with packing material. 3. Unavoidably, about 1% to 2% of mailed-in specimens are not viable. 4. Bloody specimens are undesirable. 5. If the specimen does not grow in culture, you will be notified within 7 days of receipt. 6. Results will be reported and also telephoned or faxed, if requested.   [NAME] Type: Autopsy Container/Tube: Sterile container with sterile Hank's balanced salt solution (Supply T132), [NAME]'s solution, or normal saline [NAME]: 4-mm diameter Collection Instructions: 1. Wash biopsy site with an antiseptic soap. 2. Thoroughly rinse area with sterile water. 3. Do not use alcohol or iodine preparations. 4. Biopsy specimens are best taken by [NAME] to include full thickness of dermis. Specimen Stability Information: Refrigerated (preferred)/Ambient   Specimen Type: Blood Container/Tube: Green top (sodium heparin) [NAME]: 5 mL Collection Instructions: 1. Invert several times to mix blood. 2. Other anticoagulants are not recommended and are harmful to the viability of the cells. Specimen Stability Information: Ambient (preferred)/Refrigerated  	 [NAME]: 15-mL tube containing 15 mL of transport media [NAME]: 20-25 mg Collection Instructions: 1. Collect specimen by the transabdominal or transcervical method. 2. Transfer the CVS to a Petri dish containing transport medium (Supply T095). 3. Using a stereomicroscope and sterile forceps, assess the quality and quantity of the villi and remove any blood clots and maternal decidua. Specimen Stability Information: Refrigerated (preferred)/Ambient   Specimen Type: Fixed cell pellet Container/Tube: Sterile container with a 3:1 fixative (methanol:glacial acetic acid) [NAME]: Entire specimen Specimen Stability Information: Ambient (preferred)/Refrigerated   Specimen Type: Products of conception or stillbirth Container/Tube: Sterile container with sterile Hank's balanced salt solution (Supply T132), [NAME]'s solution, or normal saline [NAME]: 1 cm(3) of placenta (including 20 mg of chorionic villi) and a 1-cm(3) biopsy specimen of muscle/fascia from the thigh Collection Instructions: If a fetus cannot be specifically identified, collect villus material or tissue that appears to be of fetal origin. Specimen Stability Information: Refrigerated (preferred)/Ambient Additional Information: Do not send entire fetus. Forms: Final Disposition of Fetal/Stillborn Remains (if fetal specimen is sent) in Special Instructions.   Specimen Type: Skin biopsy Container/Tube: Sterile container with sterile Hank's balanced salt solution (Supply T132), [NAME]'s solution, or normal saline [NAME]: 4-mm diameter Collection Instructions: 1. Wash biopsy site with an antiseptic soap. 2. Thoroughly rinse area with sterile water. 3. Do not use alcohol or iodine preparations. 4. A local anesthetic may be used. 5. Biopsy specimens are best taken by [NAME] to include full thickness of dermis. Specimen Stability Information: Refrigerated (preferred)/Ambient | Amniotic Fluid: 5 mL/Autopsy, Sk | Hemolysis	NA Thawing	NA Lipemia	NA Icterus	NA Other	Clotted blood | An interpretive report will be provided. | Samples processed Monday through Sunday. Results reported Monday through Friday, 8 a.m.-5 p.m. CST. | 2-7 days | 10 days |  | Profile |  |  |  |  | Rochester
FMDL | [NAME] | VARIES | Varies |  |  |  | Ambient
FMDL | Order Question | CG169 | Source |  | Answer List
FMDL | Option | CG169-1 | Amniotic Fluid
FMDL | Option | CG169-2 | Autopsy
FMDL | Option | CG169-3 | Blood
FMDL | Option | CG169-4 | [NAME]
FMDL | Option | CG169-5 | Fixed Cell Pellet
FMDL | Option | CG169-6 | Products of Conception or Stillbirth
FMDL | Option | CG169-7 | [NAME]
FMDL | Order Question | CG171 | Reason For Referral |  | Plain Text
FMDL | Result | 23321 | [NAME] | [NAME] | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 31208-2
FMDL | Result | 23322 | [NAME] | [NAME] | Alphanumeric
FMDL | Result | CG169 | Source | Source | Alphanumeric
FMDL | Result | 23324 | Order Date | Order Date | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
FMDL | Result | CG171 | Reason For Referral | Reason For Referral | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 42349-1
FMDL | Result | 23326 | Method | Method | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
FMDL | Result | 23327 | Results | Results | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 48974-0
FMDL | Result | 23328 | Interpretation | Interpretation | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 69965-2
FMDL | Result | 23329 | Amendment | Amendment | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
FMDL | Result | 23330 | Reviewd By: | Reviewd By: | Alphanumeric
FMDL | Result | 23331 | Release Date | Release Date | Alphanumeric
FMDL | Billing Component | FMDL |  | Cytogenetic Interp/Report |  |  |  |  |  |  |  |  |  |  |  |  |  | 1 | 88291
FMDL | Billing Component | FMDL |  | Molecular Cyto, DNA Probe |  |  |  |  |  |  |  |  |  |  |  |  |  | 2 | 88271
FMDL | Billing Component | FMDL |  | Molecular Gene,10-30 cell |  |  |  |  |  |  |  |  |  |  |  |  |  | 1 | 88273