X-linked Adrenoleukodystrophy (X-ALD) Full Gene Sequencing
Laboratory Fee Schedule
Procedure #
CPT: 81405
| Synonym(s): | X-ALD |
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| Requisition Form | G-1B (G-1B form ordering information) |
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| Test Description | X-linked Adrenoleukodystrophy (X-ALD) Full Gene Sequencing |
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| Pre-Approval Needed | N/A |
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| Supplemental Information Required | N/A |
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| Supplemental Form(s) | N/A |
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| Performed on Specimens from (sources) | Human |
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| Sample/Specimen Type for Testing | - Dried filter paper blood spots
- EDTA anticoagulated (purple top tube) whole blood
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Minimum Volume/Size Required
| - One ½ inch dried filter paper blood spot
- 1mL whole blood
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| Storage/Preservation Prior to Shipping | Dried filter paper blood specimens - Allow card to dry thoroughly at room temperature in a horizontal position for at least 3 hours. Do NOT allow specimen to touch any surface.
- Cover dried specimen with attached flap.
Whole blood specimens - Refrigerate whole blood samples until shipment.
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| Transport Medium | EDTA acceptable for whole blood |
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| Specimen Labeling | Ship all specimens according to Dangerous Good Regulations, IATA, and/or CFR 49. DRIED FILTER PAPER BLOOD SPECIMENS - U.S. Postal regulations require Double containment of dried blood filter paper specimens. Ensure specimens are thoroughly dried prior to placing in envelope.
- 1st containment: Use the attached wrap-around cover with printed universal biohazard symbol. Do not put biohazard labels on outside of envelope.
- 2nd containment: Place dried filter paper blood specimen in an envelope that is not hermetically sealed. Do not put specimens in plastic bags.
- Ship as soon as possible; within 24hrs of collection.
- Avoid temperatures greater than 100°F.
WHOLE BLOOD SHIPPING REQUIREMENT - Refrigerate sample until shipment.
- Whole blood specimens must be shipped overnight at room temperature or refrigerated and received within 7 days of collection.
- U.S. Postal regulations require Triple containment: See instructions on how to triple contain a specimen for shipping.
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| Method | PCR Amplification and Sanger Sequencing |
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| Turn-around Time | 14 working days |
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| Common Causes for Rejection | - Use of expired specimen collection device
- No date of collection provided
- Coagulated blood or insufficient amount of blood
- Patient information incomplete or invalid
- Patient name on specimen does not match name on request form.
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| Additional Information | Interpretation: Available on the result report.
Diagnostic Information: X-ALD DNA testing is performed in support of the Newborn Screening Program at DSHS and for other individuals. X-ALD Sanger sequencing methodology can detect approximately 97% of the known variants in this gene. Test results should not be used as a diagnostic test, but should be interpreted in the context of clinical findings, family history, and other laboratory data.
Additional information for specimen collection: |
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