CHROMOSOME ANALYSIS AUTOPSY STILLBIRTH OR PRODUCTS OF CONCEPTION

General Information

HLAB/HOL Code: CHPOC
UPHSM LIS Test #: 0000
Schedule: Monday through Sunday
Testing Time: 21 Days
Testing Lab: Mayo Labs

Specimen Info
Only 1 specimen type required, unless otherwise specified

Volume: See Below
Temperature: Refrigerate
Tube Type: Tissue
Collection Info:
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.

Preferred:
Specimen Type: Products of conception or stillbirth
Container/Tube: Sterile container with sterile Hank's balanced salt solution (Supply T132), Ringer's solution, or normal saline
Specimen Volume: 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:
Specimen Type: Autopsy
Container/Tube: Sterile container with sterile Hank's balanced salt solution (Supply T132), Ringer's solution, or normal saline
Specimen Volume: 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 punch biopsy to include full thickness  of dermis.

Alternate:
Specimen Type: Chorionic villus
Container/Tube: 15-mL tube containing 15 mL of transport media Specimen Volume: 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.

Methods

Generally includes 2 banded karyograms and the analysis of 20 metaphase cells.

If the chromosome study fails to produce dividing cells, this test will be resulted at no charge, and POC Aneuploidy Detection, FISH (POCRF) will be performed.

CPT Codes

88291-Interpretation and report
The following CPT codes will be applied as appropriate:
88233-Tissue culture for skin/biopsy
88262 w/modifier 52-Chromosome analysis less than 15 cells
88262- Chromosome analysis with 15 to 120 cells
88262, 88285-Chromosome analysis with greater than 20 cells
88280-Chromosome analysis, greater than 2 karyotypes
88283- Additional specialized banding technique

* The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding
is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

Reference Range

An interpretive report will be provided.