Medical Genetics Test Details

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The American Medical Association (AMA) Current Procedural Terminology (CPT) codes and Healthcare Common Procedure Coding System (HCPCS) codes listed, are provided for informational purposes only. The codes reflect our interpretation of CPT/HCPCS coding requirements based upon AMA guidelines published annually. CPT/HCPCS codes are provided only as guidance to assist clients with billing. Baylor Genetics strongly recommends that clients confirm CPT/HCPCS codes with their Medicare Administrative Contractor (MAC) or other payer being billed, as requirements may differ. CPT coding is the sole responsibility of the billing party. Baylor Genetics assumes no responsibility for billing errors due to reliance on the CPT codes listed. Please direct any questions regarding CPT coding to the payer being billed.

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Myopathy/Rhabdomyolysis Panel by Massively Parallel Sequencing (BCM-MitomeNGS^SM)
Test Information:	Metabolic myopathies are genetic disorders of energy metabolism due to defects in the pathways of carbohydrate and fatty acid catabolism, and the subsequent energy production through mitochondrial oxidative phosphorylation. Mutations in genes involved in three major pathways of energy metabolism, including glycogenolysis, fatty acid oxidation, and mitochondrial oxidative phosphorylation are the main causes of metabolic myopathies. These groups of diseases are clinically heterogeneous with variable penetrance, severity and age of onset. The predominant clinical symptoms associated with metabolic myopathy include chronic muscle weakness, myoglobinuria, and/or acute and recurrent episodes of irreversible muscle dysfunction related to exercise intolerance. Patients with metabolic myopathy are usually diagnosed based on their clinical features, abnormal metabolites, and enzymatic deficiency. However, the biochemical and molecular analytical procedures are time-consuming, costly, and often not confirmatory. Definitive diagnosis is made through the identification of deleterious mutations in the causative gene. Early diagnosis of these conditions is important for prompt clinical management and improved outcome of the patients.
Test Details
Test Code:	2300
Special Notes:	Twenty-five nuclear genes involved in energy metabolism are analyzed by the newly developed and clinically validated approach of Massively Parallel Sequencing (MPS) using Next Generation Sequence (NGS) technology. The genes analyzed by this panel are tabulated below. Sanger sequencing of these genes is also available using the associated individual test codes. ACADM (#3115), ACADVL (#3355), ACAD9 (#3900), AGL (#33670), C10orf2 (#3175), CPT2 (#3160), GAA (#3400), GYS1 (#3835), HADHA (#3120), HADHB (#3630), LPIN1 (#3280), OPA1 (#3465), OPA3 (#3525), PFKM (#3820), PGAM2 (#3805), PGM1 (#2520), PHKA1 (#3985), POLG (#3065), POLG2 (#3380), PYGM (#3800), RRM2B (#3420), SLC22A5/OCTN2 (#3360), SUCLA2 (#3375), TK2 (#3070), TYMP (#3060) All coding exons of these 25 nuclear genes and at least 20 base pairs of flanking intronic sequences are analyzed. All exonic variants and intronic variants within 20 bp of the exon/intron boundary will be reported. Sequence analysis will not detect genomic structural rearrangements (e.g. heterozygous deletions, duplications, and inversions), large heterozygous insertion mutations (e.g. ALU mediated insertion), and mutations within the promoter or deep intronic regions. Mutations and novel variants detected by NGS are confirmed by Sanger sequencing. MitoMet deletion/duplication analysis (#2000) for the genes covered by this panel is also available.
Technical Information
Methodology:	Targeted Capture followed by Massively Parallel Sequencing
Gene Name:	Please see "Test Details" section for a list of genes.

Sample & Shipping Information
Test Requisition:	Mitochondrial
Specimen Type:	Blood
Requirements:	Draw blood in an EDTA (purple-top) tube(s) and send 3-5 cc (Adults/Children).
Shipping Conditions:	Ship at room temperature in an insulated container by overnight courier. Do not heat or freeze. Sample must arrive within 72 hrs.
Specimen Type:	Purified DNA
Requirements:	Send at least 5ug of purified DNA (minimal concentration of 50ng/uL; A260/A280 of ~1.7).
Shipping Conditions:	Ship at room temperature in an insulated container by overnight courier. Do not heat or freeze.
Specimen Type:	Skeletal Muscle
Requirements:	50mg for Muscle
Shipping Conditions:	Skeletal Muscle should be flash frozen in liquid nitrogen at collection with no media added, stored at -80C, and shipped by overnight courier on 3-5 lbs of dry ice.

Billing Information
Turn Around Time:	28 days
List Price:	*For Insurance or Institutional Prices, please call.
CPT Codes:	81401x1, 81404x2, 81405x4, 81406x6, 81407x2, 81479x1

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