Spreadsheet: 3450ebb3-2d2c-45d2-a91c-c5430e4dbabf
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
89041 | Test | 89041 | T-Cell Lymphoma, FISH, Tissue | T-Cell Lymphoma, FISH, Ts | Fluorescence In Situ Hybridization (FISH) with DNA Probes |  |  |  |  |  | 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 Collection Instructions:  1. Submit paraffin block with 1 corresponding hematoxylin-and-eosin slide. Unstained slides are not preferred but are acceptable. 2. Although formalin is the preferred fixative, tissue blocks may be fixed with B5 fixative.  3. Blocks will have core biopsies punched out to isolate nuclei to process for analysis.   Specimen Type: Solid tumor Collection Instructions:  1. Submit paraffin block with 1 corresponding hematoxylin-and-eosin slide. Unstained slides are not preferred but are acceptable. 2. Although formalin is the preferred fixative, tissue blocks may be fixed with B5 fixative.  3. Blocks will have core biopsies punched out to isolate nuclei to process for analysis. |  | Hemolysis	NA Thawing	NA Lipemia	NA Icterus	NA Other	[NAME] processed with Prefer fixative | An interpretive report will be provided. | Samples processed Monday through Sunday. Results reported Monday through Friday, 8 a.m.-5 p.m. CST. | 13 days |  |  | Profile |  |  |  |  | Rochester
89041 | [NAME] | TISSUE | Tissue |  |  |  | Ambient
89041 | Order Question | Q0000023 | Physician Phone Number? |  | Plain Text
89041 | Order Question | Q0000025 | Contact physician name? |  | Plain Text
89041 | Order Question | Q0000066 | Reason for referral? |  | Plain Text
89041 | Result | 19608 | Accession Number | Accession Number
89041 | Result | 19609 | Referring Pathologist/Physician | Referring Pathologist/Physician |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 46608-6 | Primary referring physician ID:ID:Pt:Provider:Nom:
89041 | Result | 19610 | Ref Path/Phys Address | Ref Path/Phys Address |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
89041 | Result | 19611 | Material: | Material:
89041 | Result | 19612 | Specimen: | Specimen: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 31208-2 | [NAME] source:Prid:Pt:[NAME]:Nom:
89041 | Result | 19613 | Microscopic Description: | Microscopic Description: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
89041 | Result | 19614 | Special Studies: | Special Studies:
89041 | Result | 19615 | Final Diagnosis: | Final Diagnosis: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 34574-4 | Path report.final diagnosis:Imp:Pt:[NAME]:Nom:
89041 | Result | 19616 | Comment: | Comment: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 48767-8 | Annotation comment:Imp:Pt:{system}:Nar:
89041 | Result | 19617 | Revision Description: | Revision Description:
89041 | Result | 19618 | Signing Pathologist: | Signing Pathologist: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 19139-5 | Pathologist name:ID:Pt:Provider:Nom:
89041 | Result | 19619 | Special Procedures: | Special Procedures:
89041 | Result | 19620 | SP Signing Pathologist: | SP Signing Pathologist:
89041 | Result | 19621 | *Previous Report Follows* | *Previous Report Follows*
89041 | Result | 19622 | [NAME]: | [NAME]: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 35265-8 | Path report.addendum:Find:Pt:[NAME]:Nar:
89041 | Result | 19623 | [NAME] Comment: | [NAME] Comment: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 22638-1 | Path report.comments:Imp:Pt:[NAME]:Nar:
89041 | Result | 19624 | [NAME] Pathologist: | [NAME] Pathologist: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 19139-5 | Pathologist name:PN:Pt:Provider:Nom:
89041 | Billing Component | 89041 |  | Interpretation and Report |  |  |  |  |  |  |  |  |  |  |  |  |  | 1 | 88291
89041 | Billing Component | 89041 |  | Interphase in situ hybridztn, 100-300 |  |  |  |  |  |  |  |  |  |  |  |  |  | 1 | 88275
89041 | Billing Component | 89041 |  | DNA Probe, each |  |  |  |  |  |  |  |  |  |  |  |  |  | 2 | 88271
89041 | [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
89041 | [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
89041 | [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
89041 | [NAME] | 19432 | Three Additional FISH Probes | Three Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
89041 | [NAME] | 19433 | Five Additional FISH Probes | Five Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
89041 | [NAME] | 19434 | Six Additional FISH Probes | Six Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
89041 | [NAME] | 19435 | Seven Additional FISH Probes | Seven Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
89041 | [NAME] | 19436 | Eight Additional FISH Probes | Eight Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
89041 | [NAME] | 19437 | Nine Additional FISH Probes | Nine Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
89041 | [NAME] | 19438 | Ten Additional FISH Probes | Ten Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
89041 | [NAME] | 19439 | Eleven Additional FISH Probes | Eleven Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
89041 | [NAME] | 19440 | Twelve Additional FISH Probes | Twelve Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
89041 | [NAME] | 19855 | Thirteen Additional FISH Probes | Thirteen Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
89041 | [NAME] | 19856 | Fourteen Additional FISH Probes | Fourteen Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
89041 | [NAME] | 19857 | Fifteen Additional FISH Probes | Fifteen Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
89041 | [NAME] | 19858 | Sixteen Additional FISH Probes | Sixteen Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
89041 | [NAME] | 19859 | Seventeen Additional FISH Probes | Seventeen Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
89041 | [NAME] | 19860 | Eighteen Additional FISH Probes | Eighteen Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
89041 | [NAME] | 19861 | Nineteen Additional FISH Probes | Nineteen Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No
89041 | [NAME] | 19862 | Twenty Additional FISH Probes | Twenty Additional FISH Probes | Fluorescence In Situ Hybridization (FISH) |  |  |  |  |  | Only orderable by internal pathology clients. |  |  |  |  |  |  |  | Profile |  |  | No | No