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Test ID LBOR0174 PharmGx Panel

Important Note

This test is rarely covered by insurance and requires that a Patient Acknowledgment for Pharmacogenomics Services form must be filled out for all Medicare and non-Medicare patients and submitted with the sample for testing to be performed. In addition, Medicare patients require an ABN Form to also be submitted with the specimen. In the absence of the appropriate signed form(s), the ordering provider/facility will be billed.

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.

Specimen Type/Requirements

Lavender top (EDTA) tube - Whole Blood

 

Blood samples will not be accepted for patients that have undergone an allogenic transplant (e.g. bone marrow or peripheral stem cell) OR that have a history of chronic lymphocytic leukemia (CLL).

 

Transfusion patients:  Wait at least 2 weeks after a packed cell/platelet transfusion, and at least 4 weeks after a whole blood transfusion prior to blood draw for testing.

 

Chemotherapy patients:  DNA quality may be affected if patient has received chemotherapy within the last 120 days.  Clients will be contacted to provide additional specimen if DNA quality is insufficient.

 

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.

 

Testing is not affected by hemolysis or lipemia.  

Specimen Volume

 Preferred Volume    2.0 - 4.0 mL  
 Minimum Volume    1.0 mL  

 

Performed Test Frequency

Monday through Friday

Report Available

5 - 7 days

Methodology

Allele-specific PCR

Performing Lab

Sanford Medical Genetics Laboratory - Sioux Falls

CPT

81418

Stability/Transport

 Room Temperature    72 hours    
 Refrigerated    7 days    Preferred for transport  
 Frozen    Not Acceptable     

 

AKA

Warfarin, Plavix, Codeine, Clopidogrel, CYP2C9, CYP2C19, CYP2D6, CYP4F2, IFNL3, CYP2C Cluster 

Additional Information

The following 11 genes are included in this panel:

 

  • CYP2C9
  • VKORC1
  • SLCO1B1
  • TPMT
  • DPYD
  • CYP2C19
  • CYP3A5
  • CYP2D6
  • CYP4F2
  • IFNL3
  • CYP2C Cluster

 

See Pharmacogenomic Panel Testing for additional information. 

Useful For

Uses for Test:

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