Spreadsheet: c3d754be-69f3-4e80-8126-c1aa4c6f6593
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
FWHS | Test | FWHS | Wolf-Hirschhorn Syndrome, 4p16.3 Deletion, FISH | Wolf-Hirschhorn, 4p 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. 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.   [NAME]: 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 Type: Chorionic villi Container/Tube: 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 chorionic villi to 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.   [NAME] cell pellet Container/Tube: Sterile container with a 3:1 fixative (methanol:glacial acetic acid) [NAME]: Entire specimen [NAME] 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. 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. | 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. | 7 days | 10 days |  | Profile |  |  |  |  | Rochester
FWHS | [NAME] | VARIES | Varies |  |  |  | Ambient
FWHS | Order Question | CG269 | Source |  | Answer List
FWHS | Option | CG269-1 | Amniotic Fluid
FWHS | Option | CG269-2 | Autopsy
FWHS | Option | CG269-3 | Blood
FWHS | Option | CG269-4 | [NAME]
FWHS | Option | CG269-5 | Fixed Cell Pellet
FWHS | Option | CG269-6 | Products of Conception or Stillbirth
FWHS | Option | CG269-7 | [NAME]
FWHS | Order Question | CG271 | Reason For Referral |  | Plain Text
FWHS | Result | 23215 | [NAME] | [NAME] | Alphanumeric
FWHS | Result | 23216 | [NAME] | [NAME] | Alphanumeric
FWHS | Result | CG269 | Source | Source | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 31208-2 | [NAME] source:Prid:Pt:[NAME]:Nom:
FWHS | Result | 23218 | Order Date | Order Date | Alphanumeric
FWHS | Result | CG271 | Reason For Referral | Reason For Referral | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 42349-1 | Reason for referral:Find:Pt:^Patient:Nar:
FWHS | Result | 23220 | Method | Method | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 49549-9
FWHS | Result | 23221 | Result | Result | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
FWHS | Result | 23222 | Interpretation | Interpretation | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 69965-2
FWHS | Result | 23223 | Amendment | Amendment | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
FWHS | Result | 23224 | Consultant | Consultant | Alphanumeric
FWHS | Result | 23225 | Released Date | Released Date | Alphanumeric
FWHS | Billing Component | FWHS |  | Cytogenetic Interp/Report |  |  |  |  |  |  |  |  |  |  |  |  |  | 1 | 88291
FWHS | Billing Component | FWHS |  | Molecular Gene,10-30 cell |  |  |  |  |  |  |  |  |  |  |  |  |  | 1 | 88273
FWHS | Billing Component | FWHS |  | Molecular Cyto, DNA Probe |  |  |  |  |  |  |  |  |  |  |  |  |  | 2 | 88271