Spreadsheet: 674a0054-cc0d-4642-97b6-b3bc0be3ec33
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
80027 | Test | 80027 | B-Cell Lymphoma, FISH, Tissue | B-Cell Lymphoma, FISH, Ts | Fluorescence In Situ Hybridization (FISH) with DNA Probes | Paraffin block with 1 corresponding H & E slide: PBHE |  |  |  | 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. Cytogenetics Hematologic FISH Panel Patient Information Sheet (Supply T603) in Special Instructions 2. If not ordering electronically, submit a Cytogenetics Hematologic Disorders Request Form (Supply T607) with the specimen.  Advise Express Mail or equivalent if not on courier service.   Submit only 1 of the following specimens:   Specimen Type: Lymph node Preferred: Tissue block  Collection Instructions: Formalin-fixed, paraffin-embedded (FFPE) tumor tissue block. Include 1 hematoxylin and [NAME] (H and E)-stained slide.   Acceptable: Slides  Collection Instructions: For each probe set ordered, 2 unstained consecutive tissue sections cut at 5 microns and placed on positively charged microscope slides. Include 1 H and E-stained slide.  	 [NAME] tumor Preferred: Tissue block Collection Instructions: FFPE-tumor tissue block. Include 1 H and E-stained slide.   Acceptable: Slides   Collection Instructions: For each probe set ordered, 2 unstained consecutive tissue sections cut at 5 microns and placed on positively charged microscope slides. Include 1 H and E-stained slide. |  | Note: No specimen should be rejected. If specimen not received at appropriate temperature, include note to laboratory. If questions, contact laboratory | An interpretive report will be provided. | Samples processed Monday through Sunday. Results reported Monday through Friday 8am-5pm CST. | 4 days | 7 days |  | Profile |  |  |  |  | Rochester
80027 | [NAME] | MIXED | Mixed |  |  |  | Ambient
80027 | Order Question | Q0000025 | Contact physician name? |  | Plain Text
80027 | Order Question | Q0000023 | Physician Phone Number? |  | Plain Text
80027 | Order Question | Q0000066 | Reason for referral? |  | Plain Text
80027 | Result | 19192 | Accession Number | Accession Number
80027 | Result | 19193 | Referring Pathologist/Physician | Referring Pathologist/Physician |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 46608-6 | Primary referring physician ID:ID:Pt:Provider:Nom:
80027 | Result | 19194 | Ref Path/Phys Address | Ref Path/Phys Address |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
80027 | Result | 19195 | Material: | Material: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
80027 | Result | 19196 | Specimen: | Specimen: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 31208-2 | [NAME] source:Prid:Pt:[NAME]:Nom:
80027 | Result | 19197 | Microscopic Description: | Microscopic Description: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
80027 | Result | 19198 | Special Studies: | Special Studies:
80027 | Result | 19199 | Final Diagnosis: | Final Diagnosis: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 34574-4 | Path report.final diagnosis:Imp:Pt:[NAME]:Nom:
80027 | Result | 19200 | Comment: | Comment: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 48767-8 | Annotation comment:Imp:Pt:{system}:Nar:
80027 | Result | 19201 | Revision Description: | Revision Description: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
80027 | Result | 19202 | Signing Pathologist: | Signing Pathologist: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 19139-5 | Pathologist name:ID:Pt:Provider:Nom:
80027 | Result | 19203 | Special Procedures: | Special Procedures:
80027 | Result | 19204 | SP Signing Pathologist: | SP Signing Pathologist:
80027 | Result | 19205 | *Previous Report Follows* | *Previous Report Follows*
80027 | Result | 19206 | [NAME]: | [NAME]: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 35265-8 | Path report.addendum:Find:Pt:[NAME]:Nar:
80027 | Result | 19207 | [NAME] Comment: | [NAME] Comment: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 22638-1 | Path report.comments:Imp:Pt:[NAME]:Nar:
80027 | Result | 19208 | [NAME] Pathologist: | [NAME] Pathologist: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 19139-5 | Pathologist name:PN:Pt:Provider:Nom:
80027 | Billing Component | 80027 |  | [NAME], DNA probe, each |  |  |  |  |  |  |  |  |  |  |  |  |  | 2 | 88271
80027 | Billing Component | 80027 |  | Cyto & Mol Cyto, interp |  |  |  |  |  |  |  |  |  |  |  |  |  | 1 | 88291
80027 | Billing Component | 80027 |  | Analyze 100-300 cells |  |  |  |  |  |  |  |  |  |  |  |  |  | 1 | 88275
80027 | [NAME] | 19169 | One Additional FISH Probe | One Additional FISH Probe | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only to be ordered by internal pathology clients Hilton 10, 11 and E5. |  |  |  |  |  |  |  | Profile |  |  | No | No
80027 | [NAME] | 19170 | Two Additional FISH Probes | Two Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only to be ordered by internal pathology clients. Note:	An "Informed Consent for DNA Testing" (Supply T576) 	is available. See Special Instructions for a copy of the form. |  |  |  |  |  |  |  | Profile |  |  | No | No
80027 | [NAME] | 19171 | Four Additional FISH Probes | Four Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only to be ordered by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
80027 | [NAME] | 19432 | Three Additional FISH Probes | Three Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
80027 | [NAME] | 19433 | Five Additional FISH Probes | Five Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
80027 | [NAME] | 19434 | Six Additional FISH Probes | Six Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
80027 | [NAME] | 19435 | Seven Additional FISH Probes | Seven Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
80027 | [NAME] | 19436 | Eight Additional FISH Probes | Eight Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
80027 | [NAME] | 19437 | Nine Additional FISH Probes | Nine Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
80027 | [NAME] | 19438 | Ten Additional FISH Probes | Ten Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
80027 | [NAME] | 19439 | Eleven Additional FISH Probes | Eleven Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
80027 | [NAME] | 19440 | Twelve Additional FISH Probes | Twelve Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
80027 | [NAME] | 19855 | Thirteen Additional FISH Probes | Thirteen Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
80027 | [NAME] | 19856 | Fourteen Additional FISH Probes | Fourteen Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
80027 | [NAME] | 19857 | Fifteen Additional FISH Probes | Fifteen Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
80027 | [NAME] | 19858 | Sixteen Additional FISH Probes | Sixteen Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
80027 | [NAME] | 19859 | Seventeen Additional FISH Probes | Seventeen Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
80027 | [NAME] | 19860 | Eighteen Additional FISH Probes | Eighteen Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
80027 | [NAME] | 19861 | Nineteen Additional FISH Probes | Nineteen Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
80027 | [NAME] | 19862 | Twenty Additional FISH Probes | Twenty Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
80027 | [NAME] | 8874 | Pathology Consultation, Limited Without Review of Patient's Medical Record | [NAME],Lmtd w/o Review of PMR |  | Varies: Var |  |  |  | Varies | Only to be ordered by internal pathology clients. |  |  |  |  |  |  | 1 |  |  |  | Yes | No
8874 | [NAME] | MIXED | Mixed |  |  |  | Ambient
8874 | Result | 8874 | [NAME],Lmtd w/o review of PMR | [NAME],Lmtd w/o review of PMR |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process