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Aneuploidy Analysis FISH Panel, Chromosomes 13, 18, 21, X and Y
PATIENT INFO
Patient Name:
Medical Record #:
BD: //Sex: F M
PHYSICIAN INFO
Physician Name :
Address:
Ph: ()-Fax: ()-
Additional Report to:
Ph: ()-Fax: ()-
TESTS REQUESTED
Test Name:
ICD9 Code: (required)
1. Aneuploidy Analysis FISH Panel, Chromosomes 13, 18, 21, X and Y
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SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
AFISH
Test Workstation :
CYTO
Specimen Type:
3 mL whole blood collected in sodium heparin (green top) tube. 1 cm3 tissue in sterile container with sterile transport media.
Minimum Volume:
Specimen minimum volume is 1 mL.
Cause for Rejection:
Clotted, nonsterile, gross contamination, frozen specimen, or formalin fixed tissue.
Storage:
Transport blood at room temperature. Upon arrival in laboratory, store at room temperature for no more than 24 hours. If specimen is to be stored longer than 24 hours, it should be refrigerated for up to 7 days. For Tissue, refrigerate upon arrival in laboratory.
Availability:
Mon-Fri (0700-1600) Sat (0900-1300)
Methodology:
Fluorescent in situ hybridization. 100-300 cells are analyzed using a fluorescence microscope. Images are captured digitally using image analysis software.
Special Instructions:
Include pertinent medical findings on the requisition with suspected diagnosis and/or indication(s) for testing.
Lab/Phone:
330-543-8483
TAT:
4-28 days
CPT Code:
88271x5, 88275, 88291
Panel Includes:
Analysis includes markers for 13, 18, 21, X and Y.
Synonyms:
FISH, Fluorescent in situ hybridization, FISH Panel, Trisomy Panel
Aneuploidy Analysis FISH Panel, Chromosomes 13, 18, 21, X and Y
Test ID/Workstation :
AFISH
Specimen Type:
3 mL whole blood collected in sodium heparin (green top) tube. 1 cm3 tissue in sterile container with sterile transport media.
Cause for Rejection:
Clotted, nonsterile, gross contamination, frozen specimen, or formalin fixed tissue.
Storage:
Transport blood at room temperature. Upon arrival in laboratory, store at room temperature for no more than 24 hours. If specimen is to be stored longer than 24 hours, it should be refrigerated for up to 7 days. For Tissue, refrigerate upon arrival in laboratory.
Availability:
Mon-Fri (0700-1600) Sat (0900-1300)
Methodology:
Fluorescent in situ hybridization. 100-300 cells are analyzed using a fluorescence microscope. Images are captured digitally using image analysis software.
Special Instructions:
Include pertinent medical findings on the requisition with suspected diagnosis and/or indication(s) for testing.
Lab/Phone:
330-543-8483
TAT:
4-28 days
CPT Code:
88271x5, 88275, 88291
Panel Includes:
Analysis includes markers for 13, 18, 21, X and Y.
Synonyms:
FISH, Fluorescent in situ hybridization, FISH Panel, Trisomy Panel