Cancer Probe by DNA FISH

Cytogenetics Laboratory - : Cytogenetics

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. Cancer Probe by DNA FISH
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3.
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5.
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SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test Workstation :

CYTO

Specimen Type:

Blood, Bone Marrow, Lymph Node, Tumor

Cause for Rejection:

Clotted, nonsterile, or frozen specimen

Storage:

Ambient

Availability:

Mon-Fri (0700-1600) Sat 0900-1300)

Methodology:

Cells are fixed to slides, hybridized overnight with appropriate DNA probe(s), washed, and counterstained. 10 metaphase cells or 100-300 interphase nuclei are analyzed using fluorescence microscopy and images are digitally captured using analysis software.

Special Instructions:

Include all pertinent medical findings on the requisition with suspected diagnosis and/or indication(s) for the testing. Not orderable in Epic

Lab/Phone:

330-543-8483

TAT:

7-10 days

Additional Info:

Interpretation is provided with report

CPT Code:

Interphase Analysis 88271 (each probe), 88275 Metaphase Analysis 88271 (each probe), 88274, 88291

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Cancer Probe by DNA FISH

Cytogenetics Laboratory - : Cytogenetics

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