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Test ID LBOR0142 Basic PharmGX Panel

Important Note

This testing requires that a Patient Agreement for Self-Pay Pharmacogenomic Services form must be filled out for all Medicare and non-Medicare patients and submitted with the sample for testing to be performed.

 

For patients with Blue Cross Blue Shield of North Dakota coverage, a separate completed and signed Advance Member Notice is required to be sent with the specimen.

 

All specimens should be sent in the original container and should not be aliquoted to another tube. In addition, the specimen submitted should ONLY be used for this testing and should not be shared with any other testing that would also utilize this specimen type.

Specimen Type/Requirements

Lavender top (EDTA) - Whole Blood (preferred)

Sterile container - Extracted DNA

 

All specimens should be sent in the original container and should not be aliquoted to another tube. In addition, the specimen submitted should ONLY be used for this testing and should not be shared with any other testing that would also utilize this specimen type.

 

This testing requires that a Patient Agreement for Self-Pay Pharmacogenomic Services form must be filled out for all Medicare and non-Medicare patients and submitted with the sample for testing to be performed.

 

For patients with Blue Cross Blue Shield of North Dakota coverage, a separate completed and signed Advance Member Notice is required to be sent with the specimen.

 

Testing is not affected by hemolysis or lipemia. 

 

 

Specimen Volume

 

Preferred Volume   2.0 - 4.0 mL  
Minimum Volume   1.0 mL  

 

Stability/Transport

 

Room Temperature   72 hours    
Refrigerated   7 days   preferred for transport  
Frozen   7 days    

 

Performed Test Frequency

Monday through Friday

Methodology

Allele-specific PCR

Performing Lab

Sanford Laboratories Sioux Falls

Analytic Time

5 – 7 days

AKA

Warfarin

Plavix

Codeine

Clopidogrel

CYP2C9

CYP2C19

CYP2D6

Additional Information

The following 8 genes are included in this panel:

 

  • CYP2C9
  • VKORC1
  • SLCO1B1
  • TPMT
  • DPYD
  • CYP2C19
  • CYP3A5
  • CYP2D6

 

See Basic Pharmacogenetic Panel Testing for additional information. 

CPT

81479

Useful For

Uses for Test:

  • To identify genotypes shown to have a drug-gene variant relationship.