Spreadsheet: 419356ff-59e9-4647-871e-f49271c87fd7
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
VLCKM | Test | VLCKM | Very Long Chain Acyl-CoA Dehydrogenase Deficiency, Known Mutation | VLCAD Deficiency, Known Mutation | Polymerase Chain Reaction (PCR)/DNA Sequencing Analysis (PCR is utilized pursuant to a license agreement with Roche Molecular Systems, Inc.) | EDTA (lavender-top) tube: EDTA |  |  | 1 | mL | This test can only be performed if a mutation has previously been identified in a family member of this individual.   Forms:  1. Molecular Genetics-Biochemical Disorders Patient Information Sheet (Supply T527) in Special Instructions 2. 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. 3. If not ordering electronically, submit a Molecular Genetics Request Form (Supply T245) with the specimen.   [NAME] must arrive within 96 hours of collection.   Submit only 1 of the following specimens:   Preferred: [NAME]: Lavender top (EDTA) or yellow top (ACD) [NAME]: 3 mL Collection Instructions: 1. Invert several times to mix blood. 2. Send specimen in original tube. Specimen Stability Information: Ambient (preferred)/Refrigerated   Specimen Type: Blood spot Container/Tube: Preferred: Collection card (Whatman Protein Saver 903 Paper) Acceptable: Ahlstrom 226 filter paper, or Supplemental Newborn Screening Card (Supply T493) [NAME]: 2 to 5 Blood spots on collection card (Whatman Protein Saver 903 Paper; Ahlstrom 226 filter paper; or Supplemental Newborn Screening Card, Supply T493) Collection Instructions: 1. An alternative blood collection option for a patient >1 year of age is finger stick. 2. Let blood dry on the filter paper at ambient temperature in a horizontal position for 3 hours.  3. Do not expose specimen to heat or direct sunlight.  4. Do not stack wet specimens.  5. Keep specimen dry Specimen Stability Information: Ambient (preferred)/Refrigerated   Specimen Type: Cultured fibroblasts Container/Tube: T-75 or T-25 flask [NAME]: 1 Full T-75 or 2 full T-25 flasks Specimen Stability Information: Ambient (preferred)/Refrigerated <24 hours | Blood: 1 mL/Blood Spots: 5 punch | Note: No specimen should be rejected. If specimen is not received at the appropriate temperature or in the wrong anticoagulant, include note to laboratory. Contact laboratory with questions. | An interpretive report will be provided. | Tuesday, 10 am | 10 days | 16 days | 1 | 81403 |  |  |  |  | Rochester
VLCKM | [NAME] | VARIES | Varies |  |  |  | See instructions
VLCKM | Result | 51025 | [NAME] | [NAME] | Alphanumeric
VLCKM | Result | 51026 | [NAME] | [NAME] | Alphanumeric
VLCKM | Result | 51027 | Source | Source | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 31208-2 | [NAME] source:Prid:Pt:[NAME]:Nom:
VLCKM | Result | 51028 | Order Date | Order Date | Alphanumeric
VLCKM | Result | 51029 | Reason For Referral | Reason For Referral | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 42349-1 | Reason for referral:Find:Pt:^Patient:Nar:
VLCKM | Result | 51030 | Method | Method | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 49549-9
VLCKM | Result | 51031 | Result | Result | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 73736-1 | ACADVL gene mutation analysis limited to known familial mutations:Prid:Pt:Bld/Tiss:Nar:Molgen
VLCKM | Result | 51032 | Interpretation | Interpretation | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 69047-9 | Service comment 01:Imp:Pt:[NAME]:Nom:
VLCKM | Result | 51033 | Extraction Performed? | Extraction Performed? | Alphanumeric
VLCKM | Result | 51034 | Amendment | Amendment | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
VLCKM | Result | 51035 | Reviewed By | Reviewed By | Alphanumeric
VLCKM | Result | 51036 | Release Date | Release Date | Alphanumeric