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Trisomy Analysis (Chromosome 13, 18, 21) by DNA FISH
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. Trisomy Analysis (Chromosome 13, 18, 21) by DNA FISH
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SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test Workstation :
CYTO
Specimen Type:
3 mL whole blood collected in sodium heparin (green top) tube.
Minimum Volume:
Specimen minimum volume is 1 mL.
Cause for Rejection:
Clotted, nonsterile, or frozen specimen
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.
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:
88271 (each probe), 88275, 88291
Panel Includes:
Analysis includes markers for 13, 18, 21.
Synonyms:
FISH; Fluorescent in situ hybridization
Trisomy Analysis (Chromosome 13, 18, 21) by DNA FISH
Specimen Type:
3 mL whole blood collected in sodium heparin (green top) tube.
Cause for Rejection:
Clotted, nonsterile, or frozen specimen
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.
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.