Spreadsheet: c6bc5cfb-8457-4bcb-a848-2686ae6cc1ab
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
POC | Test | POC | Chromosome Analysis, Autopsy, Products of Conception, or Stillbirth | Chromosome, Autopsy/Concep/Stillbirth | POC/8887: Includes 2 banded karyograms analysis of 20 or more metaphases, and other techniques when required. FPOCR/29924: Fluorescence In Situ Hybridization (FISH) with DNA Probes | [NAME], sterile container: SrwStlCont |  |  | 1 | cm | 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.   In POC specimens, maternal cell contamination can interfere with the interpretation of chromosome analysis. To reduce this difficulty, attempt to identify and send only fetal tissue for analysis. If multiple specimen types are sent, send each specimen in a separate container. Multiple specimens received (eg, placenta and fetal thigh) will be ordered under 1 test. All specimens will be processed separately.   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.   Preferred: [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 50-mg chorionic villi) and 1 cm(3) biopsy specimen of muscle/fascia from the thigh Collection Instructions: If a fetus cannot be specifically identified, collect 50-mg villus material or tissue that appears to be of fetal origin. Additional Information: 1. Do not send entire fetus. 2. While fresher specimens prepared as described above are preferred, we can attempt analysis on specimens that have been in less-than-ideal conditions. Forms: Final Disposition of Fetal/Stillborn Remains (if fetal specimen is sent) in Special Instructions.   Acceptable: [NAME]: 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.    Alternate: [NAME] villus Container/Tube: 15-mL tube containing 15 mL of transport media [NAME]: 50 mg Collection Instructions: 1. Collect chorionic villus specimen (CVS) by transabdominal or transcervical method. 2. Transfer CVS to a Petri dish containing transport medium.	 3. Using a stereomicroscope and sterile forceps, assess the quality and quantity of villi and remove any blood clots and maternal decidua. | [NAME]: 10 mg/Muscle-F | Hemolysis	NA Thawing	NA Lipemia	NA Icterus	NA Other	NA | 46,XX or 46,XY. No apparent chromosome abnormality. An interpretive report will be provided. | Samples processed Monday through Sunday. Results reported Monday through Friday, 8 a.m.-5 p.m. CST. | 21 days | 22 days |  | Profile |  |  |  |  | Rochester
POC | [NAME] | TISSUE | Tissue |  |  |  | Refrigerated
POC | Order Question | [NAME] | Source |  | Answer List
POC | Option | [NAME]-1 | Products of Conception or Stillbirth
POC | Option | G_767-2 | Autopsy
POC | Order Question | G_773 | Reason For Referral |  | Plain Text
POC | Result | 16095 | [NAME] | [NAME] | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 31208-2
POC | Result | 16331 | [NAME] | [NAME] | Alphanumeric
POC | Result | [NAME] | Source | Source | Alphanumeric
POC | Result | 16096 | Order Date | Order Date | Alphanumeric
POC | Result | G_773 | Reason For Referral | Reason For Referral | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 42349-1
POC | Result | 16100 | Method | Method | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
POC | Result | 50471 | [NAME] | [NAME] | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 62359-5
POC | Result | 16102 | Results | Results | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 35129-6
POC | Result | 16103 | Interpretation | Interpretation | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 69965-2
POC | Result | 16104 | Amendment | Amendment | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
POC | Result | 16105 | Consultant | Consultant | Alphanumeric
POC | Result | 16106 | Report Date | Report Date | Alphanumeric
POC | Billing Component | POC |  | Unlisted Cytogenetic Study |  |  |  |  |  |  |  |  |  |  |  |  |  | 1 | 88299
POC | Billing Component | POC |  | Cytogenetic Interp/Report |  |  |  |  |  |  |  |  |  |  |  |  |  | 1 | 88291
POC | Billing Component | POC |  | Chromosome Culture,Tissue |  |  |  |  |  |  |  |  |  |  |  |  |  | 1 | 88233
POC | [NAME] | FPOCR | [NAME], Products of Conception (POC) Reflex, FISH | [NAME], POC, FISH | Fluorescence In Situ Hybridization (FISH) with DNA Probes |  |  |  |  |  | Please 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.   Preferred: Products of Conception or Stillbirth Where a fetus is identified, obtain about 1 cm(3) of placenta (including  50-mg chorionic villi) and a 1-cm(3) biopsy specimen of muscle/fascia  from the thigh. Do not send the entire fetus. Including chorionic villi  increases the likelihood of establishing a successful culture. If a fetus  cannot be specifically identified, collect 50-mg villus material or tissue  that appears to be of fetal origin. Do not handle with hands. Aseptically  place each specimen in a screw-capped, sterile container with sterile  [NAME]'s balanced salt solution, [NAME]'s solution, or normal saline. ([NAME]'s  balanced salt solution [Supply T132] is supplied.) Label each container  with the specimen type, patient's name, and laboratory control number.  Send specimen refrigerated. [NAME] cannot be frozen. While  fresher specimens prepared as described above are preferred, we can  attempt analysis on specimens that have been in less-than-ideal  conditions. Advise Express Mail or equivalent if not on courier service. Note:	1.	If a fetus is sent, please provide a parental release form or  		complete the "Final Disposition of Fetal/Stillborn Remains" 		form and send it with the fetus. (A copy of this form can be  		found in Special Instructions.) Please note that completion  		of the form requires a parent's signature. 	2. 	If ordering electronically, please complete and submit	 		a "MayoConnect Additional Test Information Form"  		(Supply T357 or see Special Instructions) with the specimen.  		If not ordering electronically, please complete and submit a  		"Cytogenetics/AFP Congenital Disorders Request Form"  		(Supply T238) with the specimen. `	3.			An "Informed Consent for DNA Testing" (Supply 				T576) is available. See Special Instructions for a 				copy of the form.   Alternate: Autopsy Wash biopsy site with an antiseptic soap (eg, pHisoHex).  Thoroughly rinse area with sterile water. Do not use alcohol or  iodine preparations. Biopsy specimens are best taken by punch  biopsy to include full thickness of dermis. [NAME] should be 4 mm  in diameter. Aseptically place biopsy in a screw-capped, sterile  container with sterile Hank's balanced salt solution, [NAME]'s  solution, or normal saline. (Hank's balanced salt solution [Supply  T132] is supplied.) Do not handle with hands. Label container with  patient's name and laboratory control number. Send specimen  refrigerated. [NAME] cannot be frozen. Advise Express Mail or  equivalent if not on courier service. Note:	1.	 If ordering electronically, please complete and submit	 		a "MayoConnect Additional Test Information Form"  		(Supply T357 or see Special Instructions) with the specimen.  		If not ordering electronically, please complete and submit a  		"Cytogenetics/AFP Congenital Disorders Request Form"  		(Supply T238) with the specimen. `	2.			An "Informed Consent for DNA Testing" (Supply 				T576) is available. See Special Instructions for a 				copy of the form. |  | Specimens other than	Tissue Anticoagulants other than	NA Hemolysis	NA Thawing	NA Lipemia	NA Icteric	NA |  | Samples processed Monday through Sunday. Results reported Monday through Friday, 8 a.m.-5 p.m. CST. | 5 days | 8 days |  | Profile |  |  | No | No
FPOCR | [NAME] | TISSUE | Tissue |  |  |  | Ambient
FPOCR | Order Question | G_C05 | Source |  | Answer List
FPOCR | Option | G_C05-1 | Products of Conception or Stillbirth
FPOCR | Option | G_C05-2 | Autopsy
FPOCR | Order Question | G_C07 | Reason For Referral |  | Plain Text
FPOCR | Result | 50677 | [NAME] | [NAME] | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 31208-2
FPOCR | Result | 50678 | [NAME] | [NAME] | Alphanumeric
FPOCR | Result | G_C05 | Source | Source | Alphanumeric
FPOCR | Result | 50680 | Order Date | Order Date | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
FPOCR | Result | G_C07 | Reason For Referral | Reason For Referral | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 42349-1
FPOCR | Result | 50682 | Method | Method | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
FPOCR | Result | 50683 | Result | Result | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 57029-1
FPOCR | Result | 50684 | Interpretation | Interpretation | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 69965-2
FPOCR | Result | 50685 | Amendment | Amendment | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
FPOCR | Result | 50686 | Reviewed By | Reviewed By | Alphanumeric
FPOCR | Result | 50687 | Release Date | Release Date | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process