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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Global Metabolomic Assisted Pathway Screen (Global MAPS)^®
Test Information:	Metabolomic profiling is a newly-developed, large scale, semi-quantitative +screening +test that looks at perturbations in both individual analytes and pathways related to biochemical abnormalities, including but not limited to amino acid, organic acid, lipid, and nucleotide metabolism. This is a small molecule screen for compounds ranging in size from 75-1000 Da. It should be used as a screening tool for individuals who have an undifferentiated phenotype or as supportive evidence in individuals with equivocal mutations in genes related to metabolic processes. It is not intended to supplant current diagnostic testing for specific conditions nor is it intended for monitoring therapy. Any abnormalities detected on the Metabolomic Profile should be confirmed by diagnostic biochemical or molecular diagnostic testing. This test must be ordered by a physician and must be accompanied by detailed clinical information for the most informative interpretation. The following situations may render Global MAPS results uninterpretable or obscure pathologic findings: Liver failure, kidney failure, dialysis, multi-organ failure, rhabdomyolysis, cancer and treatments with chemotherapy, administration of total parenteral nutrition (TPN), administration of special diets, high-dose vitamins or supplements. In such situations, it is advised to consult with a laboratory director prior to testing. This test is not intended to screen for lysosomal storage disorders, congenital disorders of glycosylation, mucopolysaccharidoses, mucolipidoses, or other similar large molecule disorders. Indications for Testing Individual with an undifferentiated phenotype suspected to be related to perturbation in a biochemical pathway (e.g. child with developmental delay, seizures, autism, etc.) Individual with equivocal molecular test results in a gene known to be involved in small molecule metabolism Use of this test in combination with exome analysis may be most beneficial in more difficult cases or in cases where a small molecule inborn error of metabolism is suspected Screening for disorders for which specific small molecule metabolite testing is not currently available
Test Details
Test Code:	4900
Special Notes:	This test may enable the identification of new biomarkers associated with specific genetic conditions, as well as biomarkers associated with medications, disease status, and diet-related treatment. We will not analyze microbial findings in this report. Plasma or urine may be sent for this analysis. If more than one sample type is submitted, then each sample will be charged appropriately. To order test on urine samples, please use test code 4901.
Technical Information
Methodology:	The Metabolomic Profiling test will identify known metabolites in plasma or urine. The test will analyze hundreds of compounds simultaneously using a combination of LC-MS/MS technologies (>800 compounds are regularly detected in human plasma). Significant abnormalities in metabolic pathways and/or in selected single analytes may be identified. In these situations, we will recommend targeted follow-up testing (molecular and/or biochemical) for confirmation.
Test Type:	Analyte Analysis
References Values or Ranges:	Metabolites and biomarkers that fall out of the normal range will be reported relative to the general, age-specific population. Individual concentrations will not be reported.

Sample & Shipping Information
Test Requisition:	Global Metabolomic Assisted Pathway Screen
Specimen Type:	4900: Plasma
Requirements:	Draw blood in a EDTA (purple top) tube(s) and separate as soon as possible, freezing immediately. Send 1-2 cc of plasma. Store the specimen frozen at -20C. Specimen may be stored frozen for up to 7 days.
Shipping Conditions:	Ship frozen on 3-5 lbs of dry ice in an insulated container by overnight courier.
Specimen Type:	4901: Urine
Requirements:	Send 3-5 cc of a random urine. Do not add preservatives. Store the specimen frozen at -20C.
Shipping Conditions:	Ship frozen on dry ice in an insulated container by overnight courier.

Billing Information
Turn Around Time:	21 days
List Price:	*For Insurance or Institutional Prices, please call.
CPT Codes:	4900: 82016x1, 82128x1, 82180x1, 82239x1, 82247x1, 82379x1, 82383x1, 82465x1, 82507x1, 82528x1, 82533x1, 82540x1, 82542x1, 82565x1, 82725x1, 82726x1, 82746x1, 82760x1, 82947x1, 82978x1, 83150x1, 83605x1, 83789x1, 83919x1, 83945x1, 84035x1, 84207x1, 84210x1, 84252x1, 84260x1, 84377x1, 84425x1, 84446x1, 84510x1, 84525x1, 84550x1, 84590x1 4901: 81005x1, 82016x1, 82128x1, 82135x1, 82239x1, 82247x1, 82379x1, 82382x1, 82465x1, 82507x1, 82528x1, 82533x1, 82540x1, 82542x1, 82570x1, 82725x1, 82726x1, 82760x1, 82947x1, 82978x1, 83150x1, 83497x1, 83605x1, 83633x1, 83789x1, 83919x1, 83945x1, 84035x1, 84119x1, 84207x1, 84210x1, 84252x1, 84260x1, 84377x1, 84392x1, 84425x1, 84446x1, 84510x1, 84525x1, 84540x1, 84560x1, 84578x1, 84585x1, 84590x1

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