Chromosome Analysis, Bone Marrow, Neoplastic Disorder
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. Chromosome Analysis, Bone Marrow, Neoplastic Disorder
2.
3.
4.
5.
6.
SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID/Workstation :
KBMZ KARYO
Specimen Type:
Bone Marrow
Tube Type:
Green top (sodium heparin) tube
Collection Volume:
3.0 mL (minimum 0.5 mL)
Cause for Rejection:
Improper/no specimen label, clotted, non-sterile, or frozen specimen
Storage:
Ambient
Availability:
Mon-Fri (0700-1600) Sat (0900-1300)
Methodology:
Chromosome harvest of mitotic cells (with and without culturing) with G-banding
Special Instructions:
Include pertinent medical findings on the requisition with suspected diagnosis and/or indication(s) for the testing. Include copy of Pathology report. Typically must be ordered with chromosome analysis.
Lab/Phone:
330-543-8483
TAT:
2-21 days
Additional Info:
Interpretation is provided with report. Follow-up studies recommended as appropriate.
CPT Code:
88237, 88262, 88280, 88291
Synonyms:
Karyotype; Bone Marrow Karyotype; Bone Marrow Cytogenetics
Chromosome Analysis, Bone Marrow, Neoplastic Disorder
Test ID/Workstation :
KBMZ KARYO
Specimen Type:
Bone Marrow
Tube Type:
Green top (sodium heparin) tube
Collection Volume:
3.0 mL (minimum 0.5 mL)
Cause for Rejection:
Improper/no specimen label, clotted, non-sterile, or frozen specimen
Storage:
Ambient
Availability:
Mon-Fri (0700-1600) Sat (0900-1300)
Methodology:
Chromosome harvest of mitotic cells (with and without culturing) with G-banding
Special Instructions:
Include pertinent medical findings on the requisition with suspected diagnosis and/or indication(s) for the testing. Include copy of Pathology report. Typically must be ordered with chromosome analysis.
Lab/Phone:
330-543-8483
TAT:
2-21 days
Additional Info:
Interpretation is provided with report. Follow-up studies recommended as appropriate.
CPT Code:
88237, 88262, 88280, 88291
Synonyms:
Karyotype; Bone Marrow Karyotype; Bone Marrow Cytogenetics
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