Spreadsheet: 9c5c2036-8465-4d8d-b73f-415ac12da3d5
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
HNPCC | Test | HNPCC | Hereditary Nonpolyposis Colorectal Cancer (HNPCC) Screen | HNPCC Screen | TUMSI/82500: A polymerase chain reaction (PCR)-based assay is used to test for tumor microsatellite instability with the use of 5 mononucleotide repeats.  MLH1B/29005, MSH2B/29006, MSH6B/29007, PMS2B/29008: Immunohistochemistry is used to test for the presence of the following proteins: MLH1, [NAME], MSH6, and PMS2. (PCR is utilized pursuant to a license agreement with Roche Molecular Systems, Inc.) | Paraffin blocks or appropriate number of unstained sections slides: PBorUnS |  |  |  | Varies | Pathology report must accompany specimen in order for testing to be performed.   Tumor and normal tissue are required.   Specimen Type: Tissue block and slides [NAME]: Approximately 1 cm(2) of tumor and normal tissue are required. This can be 1 cm(2) in aggregate (eg, 5 unstained slides each with 0.2 cm(2) of tumor and normal tissue). Collection Instructions: Submit formalin-fixed, paraffin-embedded tissue block with corresponding [NAME] and eosin slides (preferred) or 1 slide stained with hematoxylin and eosin and 10 unstained, nonbaked slides (5-micrometer thick sections) of the tumor/normal tissue. Forms: 1. [NAME] (Supply T519) in Special Instructions 2. If not ordering electronically, submit a Molecular Genetics Request Form (Supply T245) with the specimen. |  | Hemolysis	NA Thawing	Warm OK; Cold OK Lipemia	NA Icterus	NA Other	NA | An interpretive report will be provided. | Monday; 4 p.m. | 14 days | 21 days | 1 | 81301 |  |  |  |  | Rochester
HNPCC | [NAME] | VARIES | Varies |  |  |  | Ambient
HNPCC | Component | TUMSI | Microsatellite Instability (MSI), Tumor | Microsatellite Instability, Tumor | Polymerase Chain Reaction (PCR) Analysis (PCR is utilized pursuant to a license agreement with Roche Molecular Systems, Inc.) | Plastic screw-cap vial: PlScr |  |  | 200 | mg | [NAME]: Tissue  Container/Tube: Plastic container [NAME]: 200 mg Collection Instructions:  1. Specimen must be frozen within 1 hour of collection. 2. Sections should contain both tumor and normal tissue. Additional Information: Include relevant clinical and family history information, as well as a pathology report and a brief history. Forms:  1. [NAME] (Supply T519) in Special Instructions is required.  2. An Informed Consent for DNA Testing (Supply T576) is available in Special Instructions. |  | Hemolysis	NA Thawing	Warm OK; Cold OK Lipemia	NA Icterus	NA Other	NA | An interpretive report will be provided. | Tuesday, Friday; 2 p.m. Paraffin-embedded tissue already mounted on slides received by Tuesday will be set up on Friday. Paraffin-embedded tissue already mounted on slides received Friday will be set up the following Tuesday. To allow time for slide prepa | 10 days | 14 days | 1 | 81301 |  |  | Yes | Yes (Order MSIO)
TUMSI | [NAME] | VARIES | Varies |  |  |  | Ambient
TUMSI | Result | 17155 | [NAME] | [NAME] | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 31208-2
TUMSI | Result | 17156 | [NAME] | [NAME] | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
TUMSI | Result | 17157 | Source | Source | Alphanumeric
TUMSI | Result | 17158 | Order Date | Order Date | Alphanumeric
TUMSI | Result | 17160 | Reason For Referral | Reason For Referral | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 42349-1
TUMSI | Result | 17159 | Method | Method | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 49549-9
TUMSI | Result | 17161 | Results | Results | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 43368-0
TUMSI | Result | 17162 | Interpretation | Interpretation | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 69047-9
TUMSI | Result | 29383 | Extraction Performed? | Extraction Performed? | Alphanumeric
TUMSI | Result | 17163 | Amendment | Amendment | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
TUMSI | Result | 17164 | Consultant | Consultant | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
TUMSI | Result | 17165 | Report Date | Report Date | Alphanumeric
HNPCC | Component | IHCO | [NAME] (MMR) Protein Immunohistochemistry Only, Tumor | MMR Protein, IHC Only, Tumor | Immunohistochemical Staining for MLH1, [NAME], MSH6, and PMS2 | Paraffin blocks or appropriate number of unstained sections slides: PBorUnS |  |  |  | Varies | Tumor and normal tissue are required.  [NAME]: Tissue block and slide Collection Instructions: 1. Submit formalin-fixed, paraffin-embedded tissue block (preferred) or 1 slide stained with hematoxylin-and-eosin and 10 unstained, nonbaked slides (5-micron thick sections) of the tumor tissue. 2. Sections should contain both tumor and normal tissue. Forms: 1. [NAME] (Supply T519) in Special Instructions 2. If not ordering electronically, submit a Molecular Genetics Request Form (Supply T245) with the specimen. |  | Hemolysis	NA Thawing	Warm OK; Cold OK Lipemia	NA Icterus	NA Other	NA | An interpretive report will be provided. | Monday through Friday; Varies | 7 days | 10 days |  |  |  |  | Yes | Yes
IHCO | [NAME] | VARIES | Varies |  |  |  | Ambient
IHCO | Result | 29685 | [NAME] | [NAME] | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 31208-2
IHCO | Result | 29686 | [NAME] | [NAME] | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
IHCO | Result | 29687 | Source | Source | Alphanumeric
IHCO | Result | 29688 | Order Date | Order Date | Alphanumeric
IHCO | Result | 29689 | Reason For Referral | Reason For Referral | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 42349-1
IHCO | Result | 29690 | Method | Method | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 49549-9
IHCO | Result | 29691 | [NAME] | [NAME] | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 50322-7
IHCO | Result | 29692 | MSH2 IHC | MSH2 IHC | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 50323-5
IHCO | Result | 29693 | MSH6 IHC | MSH6 IHC | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 50324-3
IHCO | Result | 29694 | PMS2 IHC | PMS2 IHC | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 50328-4
IHCO | Result | 29695 | Result | Result | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
IHCO | Result | 29696 | Interpretation | Interpretation | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 59465-5
IHCO | Result | 29697 | Amendment | Amendment | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
IHCO | Result | 29698 | Reviewed By: | Reviewed By: | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
IHCO | Result | 29699 | Release Date | Release Date | Alphanumeric
IHCO | [NAME] | MLH1B | MLH-1, Immunostain | MLH-1, Immunostain |  |  |  |  |  |  | No specimen required. This is a [NAME] Only test. |  |  |  |  |  |  | 1 | 88342 |  |  | Yes | No (bill only)
MLH1B | [NAME] | VARIES | Varies |  |  |  | See instructions
IHCO | [NAME] | MSH2B | MSH-2, Immunostain | MSH-2, Immunostain |  |  |  |  |  |  | No specimen required. This is a Bill Only Test. |  |  |  |  |  |  | 1 | 88342 |  |  | Yes | No (bill only)
MSH2B | [NAME] | VARIES | Varies |  |  |  | See instructions
IHCO | [NAME] | MSH6B | MSH-6, Immunostain | MSH-6, Immunostain |  |  |  |  |  |  | No specimen required. This is a [NAME] Only test. |  |  |  |  |  |  | 1 | 88342 |  |  | Yes | No (bill only)
MSH6B | [NAME] | VARIES | Varies |  |  |  | See instructions
IHCO | [NAME] | PMS2B | PMS-2, Immunostain | PMS-2, Immunostain |  |  |  |  |  |  | No specimen required. This is a [NAME] Only test. |  |  |  |  |  |  | 1 | 88342 |  |  | Yes | No (bill only)
PMS2B | [NAME] | VARIES | Varies |  |  |  | See instructions
HNPCC | [NAME] | MLH1B | MLH-1, Immunostain | MLH-1, Immunostain |  |  |  |  |  |  | No specimen required. This is a [NAME] Only test. |  |  |  |  |  |  | 1 | 88342 |  |  | Yes | No
MLH1B | [NAME] | VARIES | Varies |  |  |  | See instructions
HNPCC | [NAME] | MSH2B | MSH-2, Immunostain | MSH-2, Immunostain |  |  |  |  |  |  | No specimen required. This is a Bill Only Test. |  |  |  |  |  |  | 1 | 88342 |  |  | Yes | No
MSH2B | [NAME] | VARIES | Varies |  |  |  | See instructions
HNPCC | [NAME] | MSH6B | MSH-6, Immunostain | MSH-6, Immunostain |  |  |  |  |  |  | No specimen required. This is a [NAME] Only test. |  |  |  |  |  |  | 1 | 88342 |  |  | Yes | No
MSH6B | [NAME] | VARIES | Varies |  |  |  | See instructions
HNPCC | [NAME] | PMS2B | PMS-2, Immunostain | PMS-2, Immunostain |  |  |  |  |  |  | No specimen required. This is a [NAME] Only test. |  |  |  |  |  |  | 1 | 88342 |  |  | Yes | No
PMS2B | [NAME] | VARIES | Varies |  |  |  | See instructions
HNPCC | [NAME] | SLRVW | Slide Review | Slide Review |  |  |  |  |  |  | For billing purposes only. |  |  |  |  |  |  | 1 | 88381 |  |  | Yes | No