Spreadsheet: cb185752-9816-419e-aa1d-d58f320de462
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
5368 | Test | 5368 | Central Nervous System Consultation, Autopsy | Central [NAME],Autopsy | Includes hematoxylin-and-esosin stains. Additional special stains or procedures necessary for diagnosis will be billed separately. | Central Nervous System [NAME]: Supply T633 |  |  |  | Varies | It is imperative that detailed clinical information and, when possible, operative notes and radiographs accompany the specimen. [NAME]-and-eosin stained sections are also acceptable but must be accompanied by paraffin blocks and/or remaining wet tissue.   Forms: 1. If not ordering electronically, submit a Pathology/Cytology Request Form (Supply T246) with the specimen. 2. Submitting Brain/Spinal Cord for Examination in Suspected Neurodegenerative Disorders or Submitting Brain for Neuropathologic Examination-Cases Suspected of Creutzfeldt-Jakob Disease (CJD) in Special Instructions.   Upon completion of consultation, the brain tissue will be stored indefinitely in the Mayo Clinic Tissue Registry. The Mayo Clinic policy precludes our evaluation of cases under litigation that involve non-Mayo Clinic patients.   Preferred:	 [NAME] brain (and spinal cord when indicated) Container/Tube: Container with 10% formalin and plastic bag [NAME]: Entire brain Collection Instructions: 1. Divide brain in half. 2. Place half the brain in 10% formalin if non-CJD, and 15% formalin for suspected cases of CJD, suspended by a thread under the basilar artery and fixed for 7 to 10 days. 3. Place other half of the brain into a plastic bag labeled with identifying information (ie, patient name, date of birth, autopsy number, and date of collection). Freeze and store in a -70 degrees C freezer. 4. Ship specimen using the Central Nervous System Consult Kit (Supply T633).   Acceptable: [NAME]: Tissue Sources: Brain (and spinal cord when indicated) Container/Tube: Plastic container  [NAME]: 1 cm(3) cube Collection Instructions: 1. Take a small (1 cm[3]) cube of brain from 1 of the frontal lobes (typically, right inferior frontal). 2. Wrap in aluminum foil and place in plastic container. 3. Label container with identifying information (ie, patient name, date of birth, autopsy number, and date of collection). 4. Freeze and store in a -70 degrees C freezer. 5. Place the remaining brain in 10% formalin if non-CJD, and 15% formalin for suspected cases of CJD, suspended by a thread under the basilar artery and fixed for 7 to 10 days. 6. Ship specimen using the Central Nervous System Consult Kit (Supply T633). |  | Hemolysis	NA Thawing	NA Lipemia	NA Icterus	NA Other	NA | This request will be processed as a consultation. Appropriate dissection will be performed and an interpretive report provided. | Monday through Friday |  | 60 days | 1 | 88036 |  |  |  |  | Rochester
5368 | [NAME] | TISSUE | Tissue |  |  |  | Ambient
5368 | Result | 18483 | Accession Number | Accession Number
5368 | Result | 18484 | Referring Pathologist/Physician | Referring Pathologist/Physician |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 46608-6
5368 | Result | 18485 | Ref Path/Phys Address | Ref Path/Phys Address |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
5368 | Result | 18486 | Place of Death: | Place of Death: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 21987-3
5368 | Result | 18487 | Date and Time of Death: | Date and Time of Death: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 31211-6
5368 | Result | 18488 | Date of Autopsy: | Date of Autopsy: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
5368 | Result | 18489 | Specimen: | Specimen: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 31208-2
5368 | Result | 18490 | Material: | Material: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
5368 | Result | 18491 | Tissue Description: | Tissue Description: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 22634-0
5368 | Result | 18492 | Microscopic Description: | Microscopic Description: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
5368 | Result | 18493 | Clinical History: | Clinical History: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
5368 | Result | 18494 | Final Diagnosis: | Final Diagnosis: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 34574-4
5368 | Result | 18495 | Comment: | Comment: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 48767-8
5368 | Result | 18496 | Revision Description: | Revision Description: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
5368 | Result | 18497 | Signing Pathologist: | Signing Pathologist: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
5368 | Result | 18498 | Special Procedures: | Special Procedures:
5368 | Result | 18499 | SP Signing Pathologist: | SP Signing Pathologist:
5368 | Result | 18500 | *Previous Report Follows* | *Previous Report Follows*
5368 | Result | 18501 | [NAME]: | [NAME]: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 35265-8
5368 | Result | 19191 | [NAME] Comment: | [NAME] Comment: | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 22638-1
5368 | Result | 18502 | [NAME] Pathologist: | [NAME] Pathologist: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 19139-5