Neurology Genetics

Neurodevelopmental Disorders & Epilepsy

FMR1 CGG Repeat Analysis

Forms and Documents

Test Requisition Test Info Sheet

Test Details

  • To differentiate fragile X syndrome from other causes of intellectual disability and autism spectrum disorders
  • Preconception/prenatal carrier testing for women with a personal or family history of fragile X syndrome, unexplained intellectual disability, autism spectrum disorders, or POI
  • Carrier testing for at-risk relatives
  • PCR Fragment Analysis

Ordering

522
2 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81243x1
Yes
Yes
  • 759.83 Fragile X syndrome
  • 781.3 Lack of coordination Ataxia NOS Muscular incoordination Excludes: ataxic gait (781.2) cerebellar ataxia (334.0-334.9) difficulty in walking (719.7) vertigo NOS (780.4)
  • 256.39 Other ovarian failure Delayed menarche Ovarian hypofunction Primary ovarian failure NOS
  • 299 Pervasive developmental disorders
  • 315.9 Unspecified delay in development, Developmental disorder NOS, Learning disorder NOS
  • 319 Unspecified mental retardation, Mental deficiency NOS, Mental subnormality NOS
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Chromosomal Microarray (GenomeDx®)

Forms and Documents

Test Info Sheet Medical Necessity Template GenomeDx VTP Details Test Requisition

Test Details

  • Confirmation of a clinical diagnosis
  • Differentiation between de novo and familial cases
  • Improved recurrence risk and prognosis
  • Prenatal diagnosis in at-risk pregnancies.
  • Whole Genome Chromosomal Microarray

Ordering

910
3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81229x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Autism/ID Panel

Forms and Documents

Test Requisition Test Info Sheet Letter of Medical Necessity

Test Details

ADNP, AHDC1, ANKRD11, ARID1A, ARID1B, ASXL1, ASXL3, ATRX, AUTS2, CACNA1A, CASK, CDKL5, CHD2, CHD7, CHD8, CLCN4, CNTNAP2, CREBBP, CSNK2A1, CTCF, CTNNB1, CTNND2, DDX3X, DHCR7, DNMT3A, DYNC1H1, DYRK1A, EFTUD2, EHMT1, EP300, FOXG1, FOXP1, GATAD2B, GNAO1, GPC3, GRIA3, GRIN1, GRIN2B, HUWE1, IL1RAPL1, IQSEC2, ITPR1, KAT6A, KAT6B, KCNB1, KDM5C, KDM6A, KIAA2022, KIF1A, KMT2A, KMT2D, MAP2K1, MBD5, MECP2, MED12, MED13L, MEF2C, MTOR, MYT1L, NALCN, NF1, NR2F1, NRXN1, NSD1, OPHN1, PACS1, PLA2G6, POGZ, PPP2R5D, PQBP1, PTCHD1, PTEN, PTPN11, PURA, RAI1, RIT1, RPS6KA3, SATB2, SCN1A, SCN2A, SCN8A, SETBP1, SETD5, SHANK3, SLC6A1, SLC6A8, SLC9A6, SMARCA2, SMARCA4, SMC1A, SOS1, STXBP1, SYNGAP1, TBL1XR1, TCF4, TRIO, TSC1, TSC2, UBE3A, USP9X, WAC, WDR45, ZC4H2, ZEB2
  • Molecular confirmation of a clinical diagnosis
  • To assist with decisions about treatment and management of individuals with autism or intellectual disability
  • Testing of at-risk relatives for specific known variant(s) previously identified in an affected family member
  • Prenatal diagnosis for known familial pathogenic variant(s) in at-risk pregnancies
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

T395
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81302x1, 81321x1, 81323x1, 81404x2, 81405x2, 81406x2, 81407x1, 81408x2
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Autism/ID Xpanded Panel

Forms and Documents

Test Requisition Gene List Family Member Test Requisition Test Info Sheet

Test Details

A2ML1, AAAS, AARS, AARS2, AASS, ABAT, ABCA13, ABCA2, ABCA5, ABCA7, ABCB5, ABCB7, ABCC12, ABCC8, ABCC9, ABCD1, ABCD3, ABCD4, ABHD5, ABL1, ACACB, ACAD9, ACADM, ACADS, ACADSB, ACAT1, ACAT2, ACBD6, ACD, ACE, ACMSD, ACO2, ACOT7, ACOX1, ACOX2, ACP5, ACSF3, ACSL4, ACTA1, ACTB, ACTG1, ACTL6A, ACTL6B, ACVR1, ACVRL1, ACY1, ADAM17, ADAM22, ADAMTS1, ADAMTS10, ADAR, ADAT3, ADCK3, ADCK4, ADCY5, ADD3, ADGRG1, ADIPOR1, ADK, ADNP, ADRA2B, ADSL, AFF2, AFF3, AFF4, AFG3L2, AGA, AGGF1, AGK, AGL, AGMO, AGO1, AGPAT2, AGTR2, AGXT2, AHCY, AHDC1, AHI1, AHRR, AHSG, AIFM1, AIMP1, AIMP2, AKAP13, AKR1C2, AKT1, AKT2, AKT3, ALAD, ALDH18A1, ALDH1A3, ALDH1B1, ALDH3A2, ALDH4A1, ALDH5A1, ALDH6A1, ALDH7A1, ALDOA, ALDOB, ALG1, ALG11, ALG12, ALG13, ALG2, ALG3, ALG6, ALG8, ALG9, ALMS1, ALPI, ALPL, ALX1, ALX3, ALX4, AMACR, AMER1, AMMECR1, AMPD1, AMPD2, AMT, ANK2, ANK3, ANKH, ANKLE2, ANKRD11, ANKS1A, ANKS1B, ANKS3, ANO10, ANO3, ANTXR1, ANXA1, AP1S1, AP1S2, AP2S1, AP3B1, AP3B2, AP3D1, AP4B1, AP4E1, AP4M1, AP4S1, AP5Z1, APAF1, APBA2, APC2, APOA1BP, APOL2, APOL4, APOPT1, APTX, AQP2, ARCN1, ARFGEF2, ARG1, ARHGAP24, ARHGAP31, ARHGAP4, ARHGDIA, ARHGEF15, ARHGEF2, ARHGEF4, ARHGEF6, ARHGEF9, ARID1A, ARID1B, ARID2, ARID4A, ARL13B, ARL14EP, ARL6, ARL6IP6, ARMC5, ARMC9, ARNT2, ARSA, ARSE, ARSF, ARSH, ARV1, ARVCF, ARX, ASAH1, ASB1, ASCC3, ASCL1, ASH1L, ASL, ASMT, ASNS, ASPA, ASPM, ASS1, ASTN1, ASTN2, ASXL1, ASXL2, ASXL3, ATAD1, ATAD3A, ATCAY, ATG5, ATIC, ATL1, ATN1, ATP10A, ATP13A2, ATP13A4, ATP1A2, ATP1A3, ATP1B4, ATP2A1, ATP2A2, ATP2B2, ATP2B3, ATP2B4, ATP2C2, ATP5A1, ATP5E, ATP6AP1, ATP6AP2, ATP6V0A2, ATP6V0C, ATP6V1A, ATP6V1B2, ATP7A, ATP7B, ATP8A2, ATP8B1, ATPAF2, ATR, ATRIP, ATRX, ATXN10, AUH, AUTS2, AVP, AVPR2, B3GALNT2, B3GALT6, B3GALTL, B3GAT3, B4GALNT1, B4GALT1, B4GALT7, B4GAT1, B9D1, BAZ1A, BAZ1B, BBIP1, BBOX1, BBS1, BBS10, BBS12, BBS2, BBS4, BBS5, BBS7, BBS9, BCAP31, BCKDHA, BCKDHB, BCKDK, BCL11A, BCL11B, BCOR, BCORL1, BCR, BCS1L, BDNF, BEND2, BICD2, BIN1, BIRC6, BLM, BLNK, BMP2, BMP3, BMP4, BMPER, BOD1, BOLA3, BPTF, BRAF, BRAT1, BRCC3, BRD4, BRF1, BRPF1, BRSK2, BRWD1, BRWD3, BSCL2, BSN, BSND, BTAF1, BTD, BTRC, BUB1, BUB1B, BUB3, C10ORF11, C10orf2, C11ORF73, C12ORF4, C12ORF57, C12ORF65, C19orf12, C19ORF70, C2CD3, C2ORF71, C5orf42, C8ORF37, CA2, CA4, CA5A, CA8, CABIN1, CACHD1, CACNA1A, CACNA1C, CACNA1D, CACNA1E, CACNA1G, CACNA1H, CACNA2D1, CACNA2D2, CACNA2D3, CACNB4, CACNG2, CAD, CADM1, CADPS2, CALM1, CALM2, CALM3, CAMK2A, CAMK2B, CAMK2G, CAMK4, CAMKMT, CAMTA1, CANT1, CAPN10, CAPN12, CARD9, CARS2, CASK, CASP2, CAT, CAV1, CBL, CBS, CC2D1A, CC2D2A, CCAR2, CCBE1, CCDC115, CCDC174, CCDC22, CCDC82, CCDC88A, CCDC88C, CCM2, CCND2, CCR1, CD59, CD96, CDAN1, CDC42, CDC42BPB, CDC45, CDC6, CDCA7, CDH10, CDH11, CDH15, CDH8, CDK10, CDK13, CDK5, CDK5R1, CDK5RAP2, CDK6, CDKL5, CDKN1B, CDKN1C, CDON, CECR1, CELF4, CELSR2, CELSR3, CENPE, CENPJ, CEP104, CEP120, CEP135, CEP152, CEP164, CEP19, CEP290, CEP41, CEP57, CEP63, CEP83, CEP89, CEP97, CERKL, CERS1, CERS3, CFHR1, CFHR2, CFL2, CHAF1B, CHAMP1, CHAT, CHD1, CHD2, CHD3, CHD4, CHD6, CHD7, CHD8, CHI3L1, CHKB, CHL1, CHMP1A, CHRM3, CHRNA1, CHRNA2, CHRNA4, CHRNA7, CHRNB2, CHRNE, CHRNG, CHST14, CHST3, CHSY1, CIAO1, CIC, CIT, CKAP2L, CLASP2, CLCF1, CLCN2, CLCN4, CLCNKA, CLCNKB, CLDN16, CLEC7A, CLIC2, CLIP1, CLIP2, CLK2, CLMP, CLN3, CLN5, CLN6, CLN8, CLP1, CLPB, CLPP, CLPTM1L, CLTC, CLTCL1, CMIP, CNKSR1, CNKSR2, CNNM2, CNOT3, CNPY3, CNTN2, CNTN3, CNTN4, CNTN6, CNTNAP1, CNTNAP2, CNTNAP3, CNTNAP5, COA3, COA5, COA6, COA7, COASY, COG1, COG2, COG4, COG5, COG6, COG7, COG8, COL13A1, COL18A1, COL25A1, COL27A1, COL4A1, COL4A2, COL4A3BP, COL6A6, COLEC10, COLEC11, COMT, COPB2, COQ2, COQ4, COQ5, COQ6, COQ7, COQ9, CORO1A, COX10, COX14, COX15, COX20, COX4I2, COX6B1, COX7B, COX8A, CPA6, CPE, CPLX1, CPOX, CPQ, CPS1, CPT1A, CPT1B, CPT2, CPZ, CR2, CRADD, CRB2, CRBN, CREB3L1, CREBBP, CRH, CRHR1, CRIPT, CRKL, CRLF1, CSDE1, CSF1R, CSMD1, CSNK2A1, CSNK2B, CSPP1, CSTB, CTBP1, CTC1, CTCF, CTDP1, CTLA4, CTNNA3, CTNNB1, CTNND1, CTNND2, CTR9, CTSA, CTSD, CTSF, CTSH, CUL3, CUL4B, CUL5, CUL7, CUX2, CWC27, CWF19L1, CXCR4, CXORF56, CYB5R3, CYC1, CYFIP1, CYFIP2, CYP24A1, CYP26B1, CYP27A1, CYP27B1, CYP2C9, CYP2R1, CYP2U1, D2HGDH, DAG1, DAOA, DAPK1, DARS, DARS2, DBH, DBT, DBX2, DCAF17, DCC, DCHS1, DCPS, DCX, DDC, DDHD2, DDOST, DDR2, DDX10, DDX11, DDX24, DDX3X, DDX53, DDX59, DEAF1, DENND5A, DENR, DEPDC5, DGCR2, DGCR6, DGCR8, DGKD, DGUOK, DHCR24, DHCR7, DHDDS, DHFR, DHTKD1, DHX30, DIAPH1, DIP2B, DIS3L2, DISC1, DISP1, DKC1, DLAT, DLD, DLG1, DLG2, DLG3, DLG4, DLGAP2, DLL1, DLL3, DLL4, DLX3, DLX6, DMBX1, DMD, DMXL1, DMXL2, DNA2, DNAH1, DNAH10, DNAH11, DNAH14, DNAH7, DNAJC12, DNAJC13, DNAJC19, DNAJC3, DNAJC5, DNAJC6, DNASE1L3, DNM1, DNM1L, DNMT3A, DNMT3B, DOCK3, DOCK6, DOCK7, DOLK, DONSON, DPAGT1, DPH1, DPM1, DPM2, DPM3, DPP6, DPYD, DPYS, DRD2, DRD3, DRP2, DTNB, DUOX1, DUOX2, DUOXA2, DUSP6, DVL1, DVL3, DYM, DYNC1H1, DYNC2LI1, DYRK1A, EARS2, EBF3, EBP, ECE1, ECHS1, ECM1, EDA2R, EDC3, EDNRB, EED, EEF1A2, EEF1B2, EFCAB5, EFHC1, EFHC2, EFNB1, EFR3A, EFTUD2, EGF, EHHADH, EHMT1, EIF2AK3, EIF2B1, EIF2B2, EIF2B3, EIF2B4, EIF2B5, EIF2S3, EIF4A3, EIF4E, EIF4ENIF1, ELAC2, ELK1, ELMO2, ELOVL4, ELP2, ELP4, EMC1, EMG1, EML1, EMX2, ENAH, ENG, ENPP1, ENTPD1, EOGT, EP300, EPB41L1, EPC2, EPG5, EPHA3, EPHA4, EPHA5, EPHA7, EPHB2, EPM2A, EPRS, EPT1, ERBB2IP, ERBB4, ERC1, ERCC1, ERCC2, ERCC3, ERCC4, ERCC5, ERCC6, ERCC8, ERF, ERLIN2, ERMARD, ESCO2, ESRRG, ETFA, ETFB, ETFDH, ETHE1, EVC, EVC2, EXOC4, EXOC6B, EXOSC2, EXOSC3, EXOSC8, EXT2, EXTL3, EYA1, EZH1, EZH2, EZR, FA2H, FAAH2, FABP3, FABP7, FADD, FAM111A, FAM120A, FAM126A, FAM134B, FAM151A, FAM177A1, FAM183A, FAM20C, FAM3C, FAM58A, FAM65B, FANCB, FAR1, FARS2, FAS, FASN, FASTKD2, FAT1, FAT3, FAT4, FBLN1, FBP1, FBXL4, FBXO11, FBXO18, FBXO28, FBXO31, FDXR, FEZF2, FGD1, FGF12, FGF13, FGF14, FGF17, FGF23, FGF3, FGF8, FGFR1, FGFR2, FGFR3, FGFRL1, FH, FHL1, FIBP, FIG4, FKBP10, FKBPL, FKRP, FKTN, FLI1, FLII, FLNA, FLNB, FLRT3, FLVCR1, FLVCR2, FMN1, FMN2, FMR1, FOLR1, FOS, FOXE1, FOXG1, FOXH1, FOXI1, FOXN1, FOXP1, FOXP2, FOXRED1, FRAS1, FREM2, FRG1, FRMD4A, FRMPD4, FRRS1L, FRY, FTCD, FTL, FTO, FTSJ1, FUCA1 , FXYD2, G6PC, G6PC3, GAA, GABBR2, GABRA1, GABRA3, GABRA5, GABRA6, GABRB1, GABRB2, GABRB3, GABRD, GABRE, GABRG2, GABRG3, GABRQ, GABRR1, GABRR3, GAD1, GAL, GALC, GALE, GALNT9, GALNTL5, GALT, GAMT, GAN, GAP43, GARS, GAS1, GATA1, GATA2, GATA3, GATA5, GATA6, GATAD2B, GATM, GBA, GBA2, GCDH, GCH1, GCLC, GCM2, GCSH, GDF2, GDF5, GDI1, GDNF, GEMIN4, GFAP, GFER, GFM1, GFM2, GFPT1, GIGYF2, GIT1, GJA1, GJB1, GJC2, GK, GLB1, GLDC, GLI2, GLI3, GLRA1, GLRA2, GLRB, GLRX5, GLUD1, GLUL, GLYCTK, GM2A, GMNN, GMPPA, GMPPB, GNA11, GNAI1, GNAO1, GNAQ, GNAS, GNB1, GNB1L, GNB5, GNE, GNPAT, GNPTAB, GNPTG, GNRH1, GNS, GOLGA2, GON4L, GORAB, GOSR2, GP1BB, GPAA1, GPC3, GPC4, GPC6, GPD2, GPHN, GPI, GPKOW, GPR101, GPR112, GPR161, GPR37, GPR64, GPR85, GPR88, GPRASP2, GPSM2, GPT2, GRB10, GRIA1, GRIA3, GRIA4, GRID2, GRIK2, GRIK3, GRIN1, GRIN2A, GRIN2B, GRIN2D, GRIP1, GRM1, GRM5, GRM7, GRM8, GRN, GRPR, GSPT2, GSS, GTF2E2, GTF2H5, GTF2IRD1, GTPBP2, GTPBP3, GUCY1A3, GUF1, GUSB, GYG2, GYS1, GYS2, H3F3A, H3F3B, HACE1, HADH, HAP1, HARS2, HAX1, HCCS, HCFC1, HCN1, HCN2, HCRT, HDAC1, HDAC4, HDAC6, HDAC8, HDLBP, HDX, HECW2, HELLS, HELZ, HEPACAM, HERC1, HERC2, HES7, HESX1, HEXA, HEXB, HFM1, HGSNAT, HHAT, HIBCH, HIC1, HIP1, HIRA, HIST1H1E, HIST1H4C, HIST3H3, HIVEP2, HK1, HLA-B, HLA-DPB1, HLA-DQB1, HLA-DRB1, HLCS, HMBS, HMGA2, HMGB1, HMGB3, HMGCL, HMGCS2, HMHA1, HNMT, HNRNPH2, HNRNPK, HNRNPL, HNRNPU, HOXA1, HOXA2, HPCA, HPD, HPRT1, HRAS, HSD17B10, HSD17B4, HSPA9, HSPD1, HSPG2, HTR1A, HTR2A, HTR3A, HTRA2, HUWE1, HYLS1, IARS, IARS2, IBA57, ICE2, ICK, IDH2, IDS, IDUA, IER3IP1, IFIH1, IFNAR2, IFT140, IFT172, IFT27, IFT43, IGBP1, IGF1, IGF1R, IGF2, IGSF1, IL10, IL11RA, IL12A, IL12B, IL12RB2, IL17F, IL17RA, IL1RAPL1, IL23R, IL27RA, IMMP2L, IMPA1, IMPAD1, IMPDH2, INO80, INPP4A, INPP5E, INPP5K, INPPL1, INS, INSR, INTS1, INTS8, INVS, IQCB1, IQGAP3, IQSEC1, IQSEC2, IRF2BPL, IRF9, IRX5, ISCA2, ISCU, ISPD, ITCH, ITGA3, ITGA4, ITGA7, ITGA9, ITGB6, ITK, ITPA, ITPR1, ITSN1, ITSN2, IVD, IYD, JAG1, JAM3, JARID2, JMJD1C, JPH3, JRK, KANK1, KANSL1, KARS, KAT6A, KAT6B, KATNAL2, KATNB1, KCNA1, KCNA2, KCNA4, KCNAB1, KCNAB2, KCNB1, KCNC1, KCNC3, KCND2, KCND3, KCNG1, KCNH1, KCNH7, KCNJ1, KCNJ10, KCNJ11, KCNJ13, KCNJ2, KCNJ6, KCNJ8, KCNK9, KCNMA1, KCNN3, KCNQ2, KCNQ3, KCNQ4, KCNQ5, KCNT1, KCNT2, KCNV2, KCTD13, KCTD3, KCTD7, KDELC2, KDM1A, KDM2B, KDM3A, KDM5A, KDM5B, KDM5C, KDM6A, KDM6B, KIAA0196, KIAA0226, KIAA0556, KIAA0586, KIAA0753, KIAA1033, KIAA1109, KIAA1210, KIAA1279, KIAA1715, KIAA2022, KIDINS220, KIF11, KIF14, KIF17, KIF1A, KIF23, KIF2A, KIF4A, KIF5A, KIF5C, KIF7, KIRREL3, KISS1, KLB, KLC2, KLF13, KLF8, KLHL15, KLHL24, KLHL41, KLHL7, KLLN, KLRC4, KMT2A, KMT2B, KMT2C, KMT2D, KMT2E, KNL1, KPNA7, KPTN, KRAS, KRIT1, KRT25, KRT83, KSR2, KYNU, L1CAM, L2HGDH, LAGE3, LAMA1, LAMA2, LAMB1, LAMB2, LAMC1, LAMC3, LAMP2, LARGE, LARP7, LARS, LARS2, LAS1L, LBR, LDHB, LEMD3, LEP, LETM1, LFNG, LGI1, LGI4, LGR4, LHX1, LHX3, LIAS, LIFR, LIG4, LIMK1, LIN7A, LIN7B, LINGO1, LINGO2, LINS, LIPT1, LLGL1, LMAN2L, LMBR1, LMBRD1, LMNB1, LMNB2, LONP1, LRFN2, LRP1, LRP2, LRP6, LRPPRC, LRRC4, LRRC7, LRRTM4, LTBP1, LTBP4, LTC4S, LYRM4, LYRM7, LYST, LZTFL1, MAB21L2, MACF1, MAD2L2, MADD, MAF, MAFB, MAG, MAGED2, MAGEL2, MAGI1, MAGI2, MAGT1, MAN1B1, MAN2B1, MANBA, MAOA, MAP2, MAP2K1, MAP2K2, MAP2K3, MAP3K15, MAP3K7, MAP4, MAPK1, MAPK10, MAPK3, MAPRE2, MAPT, MARS2, MASP1, MAT1A, MATN4, MBD1, MBD4, MBD5, MBD6, MBOAT7, MBTPS2, MC2R, MCCC1, MCCC2, MCEE, MCF2, MCM3AP, MCM4, MCOLN1, MCPH1, MCTP2, MDH2, MDN1, ME2, MECOM, MECP2, MED12, MED13, MED13L, MED17, MED23, MED25, MED27, MEF2C, MEFV, MEGF10, MEGF8, MEIS2, MESP2, METTL23, METTL5, MFF, MFHAS1, MFRP, MFSD2A, MFSD8, MGAT2, MGAT4C, MGME1, MGP, MICAL1, MICU1, MID1, MID2, MIPEP, MKKS, MKS1, MKX, MLC1, MLLT3, MLX, MLXIPL, MLYCD, MMAA, MMAB, MMACHC, MMADHC, MMP13, MMP8, MN1, MNX1, MOCS1, MOCS2, MOGS, MORC2, MPC1, MPDU1, MPDZ, MPLKIP, MPP7, MPV17, MRAP, MRI1, MRPL10, MRPL3, MRPL44, MRPS16, MRPS2, MRPS22, MSL3, MSMO1, MSX2, MTFMT, MTHFS, MTM1, MTMR8, MTO1, MTOR, MTPAP, MTR, MTRR, MTSS1L, MUC1, MUT, MVK, MXRA5, MXRA8, MYBPC1, MYCBP2, MYCN, MYEF2, MYH1, MYH10, MYH3, MYH8, MYO18B, MYO1C, MYO5A, MYO7B, MYO9A, MYOCD, MYOF, MYT1, MYT1L, NAA10, NAA15, NACC1, NADK2, NAGA, NAGLU, NAGPA, NAGS, NALCN, NANS, NARS2, NAT8L, NAV1, NAV2, NBAS, NBEA, NBN, NCAPD2, NCAPG2, NCKAP1, NCS1, NDE1, NDN, NDP, NDST1, NDUFA1, NDUFA10, NDUFA11, NDUFA12, NDUFA13, NDUFA2, NDUFA4, NDUFA9, NDUFAF1, NDUFAF2, NDUFAF3, NDUFAF4, NDUFAF5, NDUFAF6, NDUFB11, NDUFB3, NDUFB9, NDUFS1, NDUFS2, NDUFS3, NDUFS4, NDUFS6, NDUFS7, NDUFS8, NDUFV1, NDUFV2, NECAP1, NEDD4L, NEK9, NELFA, NEU1, NEUROD2, NF1, NFASC, NFAT5, NFE2L2, NFIA, NFIB, NFIX, NFU1, NGF, NGLY1, NHEJ1, NHLRC1, NHP2, NHS, NID1, NIN, NIPA1, NIPA2, NIPBL, NKAIN2, NKX2-1, NKX2-5, NKX6-2, NLGN1, NLGN2, NLGN3, NLGN4X, NLGN4Y, NLRP2, NLRP3, NME7, NME8, NMNAT1, NNT, NODAL, NOG, NOL3, NONO, NOP10, NOS1AP, NOTCH3, NPAP1, NPAS3, NPAS4, NPC1, NPC2, NPEPPS, NPHP1, NPHP3, NPHP4, NPHS1, NPRL2, NPRL3, NR0B1, NR2F1, NR4A2, NR5A1, NRAS, NRD1, NRG1, NRGN, NRTN, NRXN1, NRXN2, NRXN3, NSD1, NSDHL, NSUN2, NSUN7, NT5C2, NTNG1, NTRK1, NTRK2, NTRK3, NUBPL, NUP107, NUP62, NUS1, NXF3, NXF5, NXPH3, OBSCN, OCLN, OCRL, OFD1, OGDH, OGT, OMG, OPA1, OPA3, OPCML, OPHN1, OPRL1, ORC1, ORC4, ORC6, OSGEP, OTC, OTOGL, OTUD4, OTUD6B, OTUD7A, OTX1, OTX2, OXTR, P2RY11, P4HA2, P4HB, PABPC4L, PACS1, PACS2, PAFAH1B1, PAFAH1B3, PAH, PAK3, PAM16, PANK2, PANX1, PARK2, PARN, PARP1, PARP10, PARS2, PAX1, PAX2, PAX3, PAX5, PAX6, PAX8, PAXBP1, PBX1, PC, PCBD1, PCCA, PCCB, PCDH11X, PCDH12, PCDH19, PCDH7, PCDHB16, PCDHB4, PCK1, PCLO, PCM1, PCNA, PCNT, PDCD10, PDE10A, PDE4B, PDE4D, PDE6D, PDGFB, PDGFRB, PDHA1, PDHB, PDHX, PDK3, PDP1, PDSS1, PDSS2, PDYN, PDZD2, PECR, PEPD, PER1, PER2, PET100, PEX1, PEX10, PEX11B, PEX12, PEX13, PEX14, PEX16, PEX19, PEX2, PEX26, PEX3, PEX5, PEX6, PEX7, PFKFB1, PGAP1, PGAP2, PGAP3, PGK1, PGM1, PGM3, PGRMC1, PHC1, PHF2, PHF21A, PHF3, PHF6, PHF8, PHGDH, PHIP, PHKA2, PHKG2, PHOX2B, PI4KA, PIBF1, PIEZO2, PIGA, PIGC, PIGG, PIGL, PIGM, PIGN, PIGO, PIGP, PIGQ, PIGS, PIGT, PIGV, PIGW, PIGY, PIK3AP1, PIK3CA, PIK3R2, PIK3R5, PITRM1, PLA2G6, PLAA, PLAGL1, PLAT, PLCB1, PLCB4, PLCG2, PLEKHG2, PLG, PLK4, PLOD3, PLP1, PLS3, PLXNA3, PLXNB3, PLXND1, PMM2, PMPCA, PNKD, PNKP, PNP, PNPLA6, PNPLA8, PNPO, PNPT1, POC1A, POC1B, PODXL, POFUT1, POGZ, POLA1, POLG, POLG2, POLR1C, POLR1D, POLR2A, POLR3A, POLR3B, POMGNT1, POMGNT2, POMK, POMT1, POMT2, POP1, POR, PORCN, POU1F1, POU3F2, PPARG, PPARGC1A, PPIB, PPM1B, PPM1D, PPM1K, PPOX, PPP1CB, PPP1R15B, PPP1R3C, PPP2R1A, PPP2R2B, PPP2R2C, PPP2R5D, PPP3CA, PPT1, PQBP1, PRCP, PRDM12, PRDM8, PRDX1, PREPL, PRF1, PRICKLE1, PRICKLE2, PRICKLE3, PRIMA1, PRKAR1A, PRKAR1B, PRKCA, PRKD1, PRKDC, PRKG1, PRKRA, PRMT7, PRMT9, PRODH, PRODH2, PROP1, PROSC, PRPF8, PRPS1, PRR12, PRRT2, PRSS12, PRTN3, PRUNE, PSAP, PSAT1, PSMD12, PSPH, PTCH1, PTCHD1, PTDSS1, PTEN, PTF1A, PTH, PTPN11, PTPN22, PTPN23, PTPRD, PTPRK, PTRH2, PTS, PUF60, PUM1, PURA, PUS1, PUS3, PVRL1, PXDN, PYCR1, PYCR2, QARS, QDPR, QRICH1, RAB11A, RAB11B, RAB11FIP5, RAB18, RAB23, RAB27A, RAB33B, RAB39B, RAB3GAP1, RAB3GAP2, RAC1, RAD21, RAD50, RAF1, RAI1, RALGAPA1, RALGDS, RANBP2, RAP1A, RAP1B, RARB, RARS, RARS2, RASA2, RBBP8, RBFOX1, RBFOX3, RBM10, RBM28, RBM8A, RBP4, RBPJ, RDH11, RECQL4, REEP1, RELN, REPS2, RERE, REV3L, RFC2, RFT1, RFWD2, RGMA, RGR, RGS7, RHEB, RHOBTB2, RILP, RIMS1, RIMS3, RIN2, RIPK1, RIPPLY1, RIPPLY2, RIT1, RLBP1, RLIM, RMND1, RNASEH2A, RNASEH2B, RNASEH2C, RNASET2, RNF113A, RNF125, RNF128, RNF135, RNF168, RNF216, ROBO1, ROBO2, ROBO3, ROGDI, ROR2, RORA, RORB, ROS1, RPGRIP1L, RPIA, RPL10, RPL11, RPL15, RPL26, RPL35A, RPS19, RPS23, RPS28, RPS6KA3, RPS6KC1, RPS7, RREB1, RRM2B, RSPRY1, RSRC1, RTEL1, RTN4IP1, RTN4R, RTTN, RUNX1T1, RUSC2, RYR2, RYR3, SACS, SALL1, SAMD11, SAMD9, SAMHD1, SAR1B, SARS, SARS2, SASS6, SATB2, SATL1, SBDS, SBF1, SC5D, SCAPER, SCARB2, SCN10A, SCN11A, SCN1A, SCN1B, SCN2A, SCN3A, SCN3B, SCN7A, SCN8A, SCN9A, SCNM1, SCO1, SCO2, SCP2, SCRIB, SCUBE2, SCYL1, SDCCAG8, SDHA, SDHAF1, SEC24C, SEC24D, SEMA3C, SEMA3D, SEMA3E, SEMA4G, SEMA5A, SEMA6D, SEPSECS, SERAC1, SERPINA7, SERPINB4, SERPINI1, SESN2, SET, SETBP1, SETD1A, SETD1B, SETD2, SETD5, SETDB2, SF3B4, SFXN4, SGCE, SGSH, SH2B1, SH3PXD2B, SHANK1, SHANK2, SHANK3, SHH, SHOC2, SHOX2, SHROOM4, SIK1, SIL1, SIM1, SIN3A, SIPA1L1, SIX3, SKI, SLC12A1, SLC12A2, SLC12A3, SLC12A5, SLC12A6, SLC13A5, SLC16A1, SLC16A2, SLC16A3, SLC17A3, SLC17A5 , SLC17A9, SLC18A2, SLC19A2, SLC19A3, SLC1A1, SLC1A2, SLC1A3, SLC1A4, SLC20A2, SLC22A25, SLC25A1, SLC25A10, SLC25A12, SLC25A15, SLC25A19, SLC25A20, SLC25A22, SLC25A24, SLC25A26, SLC25A3, SLC25A4, SLC25A43, SLC25A46, SLC25A5, SLC26A1, SLC29A4, SLC2A1, SLC2A10, SLC2A2, SLC2A3, SLC30A9, SLC31A1, SLC33A1, SLC35A1, SLC35A2, SLC35A3, SLC35C1, SLC37A4, SLC39A14, SLC39A8, SLC45A1, SLC46A1, SLC4A10, SLC4A4, SLC5A5, SLC5A6, SLC5A7, SLC6A1, SLC6A13, SLC6A17, SLC6A19, SLC6A3, SLC6A5, SLC6A8, SLC6A9, SLC7A3, SLC7A5, SLC7A7, SLC9A1, SLC9A6, SLC9A9, SLCO1B3, SLCO1C1, SLIT2, SLIT3, SLITRK1, SLITRK5, SMAD2, SMAD4, SMAD6, SMARCA2, SMARCA4, SMARCAL1, SMARCB1, SMARCC2, SMARCE1, SMC1A, SMC3, SMCHD1, SMG9, SMO, SMOC1, SMPD1, SMS, SNAP25, SNAP29, SNIP1, SNRPB, SNRPN, SNTG2, SNX10, SNX14, SNX27, SOBP, SOGA3, SON, SORCS1, SOS1, SOS2, SOST, SOX10, SOX11, SOX17, SOX2, SOX3, SOX5, SOX6, SOX9, SP7, SPARC, SPAST, SPATA5, SPECC1L, SPG11, SPG20, SPG21, SPG7, SPINK5, SPN, SPOCK1, SPP2, SPR, SPRED1, SPRY4, SPTAN1, SPTBN2, SPTBN4, SPTBN5, SQSTM1, SRCAP, SRD5A3, SRP54, SRPK2, SRPK3, SRPX2, SSR4, SSTR5, SSX1, ST3GAL3, ST3GAL5, ST5, ST7, ST8SIA2, STAC3, STAG1, STAG2, STAMBP, STAR, STARD9, STAT1, STAT2, STAT4, STIL, STIM1, STOX1, STRA6, STRADA, STT3A, STT3B, STUB1, STX11, STX16, STX1A, STX1B, STX3, STXBP1, STXBP2, STXBP5L, STYXL1, SUCLA2, SUCLG1, SUCO, SUFU, SUMF1, SUOX, SUPT16H, SURF1, SUV420H1, SUZ12, SV2A, SV2B, SVIL, SYN1, SYN2, SYNCRIP, SYNE1, SYNGAP1, SYNJ1, SYNPO, SYP, SYT1, SYT14, SYT2, SZT2, TAB2, TAC3, TACO1, TACR3, TAF1, TAF13, TAF2, TAF6, TALDO1, TANC2, TANGO2, TAOK2, TARS2, TAT, TAZ, TBC1D20, TBC1D23, TBC1D24, TBC1D30, TBC1D7, TBCD, TBCE, TBCK, TBL1XR1, TBL2, TBR1, TBX1, TBX18, TBX19, TBX2, TBX4, TBX6, TCF12, TCF20, TCF3, TCF4, TCF7L1, TCF7L2, TCIRG1, TCN2, TCTN1, TCTN2, TCTN3, TDGF1, TDP2, TECPR2, TECR, TELO2, TENM1, TENM4, TERT, TEX15, TFAP2A, TFAP2B, TG, TGDS, TGIF1, TGM2, TH, THAP11, THBS1, THG1L, THOC2, THOC6, THRA, THRB, TIMM50, TIMM8A, TIMMDC1, TINF2, TK2, TKT, TLK2, TM4SF20, TMCO1, TMEM106B, TMEM107, TMEM114, TMEM126A, TMEM126B, TMEM135, TMEM138, TMEM165, TMEM199, TMEM216, TMEM231, TMEM237, TMEM240, TMEM38B, TMEM5, TMEM67, TMEM70, TMEM8C, TMEM92, TMLHE, TMPRSS6, TMTC3, TNC, TNFRSF11A, TNFRSF11B, TNFRSF1A, TNFSF4, TNIK, TNNT1, TNPO3, TNR, TNS3, TOE1, TONSL, TOP2B, TOP3B, TOR1A, TOR1AIP1, TP53RK, TP63, TPI1, TPK1, TPM2, TPM3, TPO, TPP1, TPP2, TPRKB, TRAF3IP1, TRAF3IP2, TRAF7, TRAIP, TRAK1, TRAPPC11, TRAPPC6A, TRAPPC6B, TRAPPC9, TREM2, TREX1, TRH, TRHR, TRIM17, TRIM32, TRIM8, TRIO, TRIP12, TRIP13, TRIP4, TRIT1, TRMT1, TRMT10A, TRMT5, TRNT1, TRPC5, TRPC6, TRPM3, TRPM6, TRPM7, TRPS1, TRRAP, TSC1, TSC2, TSEN15, TSEN2, TSEN34, TSEN54, TSFM, TSHB, TSHR, TSHZ3, TSPAN7, TTC19, TTC21B, TTC8, TTI2, TUBA1A, TUBA3E, TUBA8, TUBB, TUBB2A, TUBB2B, TUBB3, TUBB4A, TUBG1, TUBGCP4, TUBGCP5, TUBGCP6, TUFM, TUSC3, TWIST1, TWIST2, TXN2, TYK2, TYMP, TYROBP, UBA5, UBA7, UBAC2, UBB, UBE2A, UBE2T, UBE3A, UBE3B, UBR1, UBR3, UBR7, UBTF, UCP2, UFD1L, UGDH, ULK4, UMPS, UNC13A, UNC13B, UNC13C, UNC13D, UNC80, UPB1, UPF3B, UQCC2, UQCC3, UQCRB, UQCRC2, UQCRQ, UROC1, USB1, USP18, USP27X, USP30, USP34, USP44, USP45, USP7, USP9X, VAC14, VAMP2, VANGL1, VARS, VARS2, VAX1, VCP, VCX3A, VDR, VIPAS39, VIPR2, VLDLR, VMA21, VPS11, VPS13A, VPS13B, VPS13C, VPS33A, VPS33B, VPS37A, VPS45, VPS4A, VPS53, VRK1, VSIG1, VSX2, VWA3B, WAC, WARS2, WDFY3, WDPCP, WDR1, WDR13, WDR19, WDR26, WDR35, WDR4, WDR45, WDR45B, WDR60, WDR62, WDR73, WDR81, WDR93, WFS1, WHSC1, WNK1, WNT1, WNT5A, WNT7A, WRAP53, WWOX, XIRP1, XK, XPA, XPC, XPNPEP3, XPO5, XPR1, XRCC1, XRCC4, XYLT1, XYLT2, YAP1, YARS, YARS2, YWHAE, YWHAG, YY1, YY1AP1, ZBTB16, ZBTB18, ZBTB20, ZBTB24, ZBTB33, ZBTB40, ZC3H14, ZC4H2, ZCCHC12, ZCCHC8, ZDHHC15, ZDHHC9, ZEB2, ZFHX4, ZFP57, ZFPM2, ZFR, ZFYVE26, ZIC1, ZIC2, ZMIZ1, ZMYM2, ZMYM3, ZMYND11, ZMYND12, ZNF107, ZNF148, ZNF277, ZNF292, ZNF335, ZNF365, ZNF385B, ZNF407, ZNF41, ZNF423, ZNF462, ZNF526, ZNF589, ZNF592, ZNF638, ZNF668, ZNF674, ZNF711, ZNF778, ZNF804A, ZNF81, ZNHIT3, ZSCAN29, ZSWIM6
  • Molecular confirmation of a clinical diagnosis
  • To assist with decisions about treatment and management of individuals with autism or intellectual disability
  • Testing of at-risk relatives for specific known variant(s) previously identified in an affected family member
  • Prenatal diagnosis for known familial pathogenic variant(s) in at-risk pregnancies
  • Next-Gen Sequencing

Ordering

952
6 weeks
2-5 mL Blood - Lavender Top Tube
Dried Blood Spots | Buccal Swabs

Billing

81470x1, 81471x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. CDC (Centers for Disease Control and Prevention) (2014) Morbidity and Mortality Weekly Report 63(SS02) 1-21; www.cdc.gov/mmwr
  2. Mefford et al., (2012) NEJM 366(8): 733-743 (PMID: 22356326)
  3. Miller et al.., (2010) Am J Hum Genet 86(5): 749-64 (PMID 20466091)
  4. Schaefer et al., (2013) Genet Med 15(5): 399-407 (PMID: 23519317)
  5. Farwell et al. (2015) Genet. Med. 17 (7):578-86 (PMID: 25356970)
  6. Lee et al. (2014) Jama 312 (18):1880-7 (PMID: 25326637)
  7. Posey et al. (2015) Genet. Med. : (PMID: 26633545)
  8. Retterer et al. (2015) Genet. Med. : (PMID: 26633542)
  9. Wright et al. (2015) Lancet 385 (9975):1305-14 (PMID: 25529582)
  10. Lopez-Rangel et al., (2008) Br J Dev Disabil 54: 69-82 (no PMID)
  11. Fitzgerald et al. (2015) Nature 519 (7542):223-8 (PMID: 25533962)
  12. McKnight D, Retterer K, Juusola J, Brandt T, Richard G, and Suchy S, Genetic Testing Strategies for Patients with Epilepsy and Neurodevelopmental Disorders; (Abstract #562). Presented at the 2015 ACMG Annual Clinical Genetics Meeting, March 27, 2015, Salt
  13. Yang et al. (2014) JAMA 312 (18):1870-9 (PMID: 25326635)
PTEN Gene Sequencing and Del/Dup

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • An adult with features of PTEN hamartoma tumor syndrome (PHTS), such as characteristic skin lesions (trichilemmomas, acral keratoses, papillomas, lipomas, etc.), macrocephaly, gastrointestinal polyps (especially hamartomas or ganglioneuromas), Lhermitte-Duclos disease, or associated cancers (breast, endometrial, non-medullary thyroid, renal, melanoma, colon), among other features
  • A child with early-onset features of PHTS, such as macrocephaly, autism, developmental delay, lipomas, penile freckling, or vascular anomalies, among other features
  • An unaffected individual with a family history suggestive of PHTS (see above) when an affected individual is unavailable for his or her own genetic testing
  • Capillary Sequencing
  • Deletion/Duplication Analysis

Ordering

195
3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs | Fibroblasts (separate charge for cell culture may apply)

Billing

81321x1, 81323x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Eng, C. Hum Mutat. 22: 183-98, 2003
  2. Marsh, D.J. et al. Hum Mol Genet. 7: 507-15, 1998
  3. Zhou, X.P. et al. Am J Hum Genet. 73: 404-11, 2003
  4. Pezzolesi, M. et al. Hum Mol Genet. 16: 1058-71, 2007
  5. Zhou, X.P. et al. Hum Mol Genet. 9: 765-8, 2000
  6. Zhou, X.P. et al. Lancet. 358: 210-1, 2001
  7. Barker, K. et al. J Med Genet. 38: 480-1, 2001
  8. Smith, J.M. et al., J Med Genet. 39: 937-40, 2002
Rett/Angelman Syndrome Panel

Forms and Documents

Test Info Sheet Test Requisition Letter of Medical Necessity

Test Details

ATRX, CDKL5, CNTNAP2, CTNNB1, DDX3X, FOXG1, GABBR2, KCNA2, MBD5, MECP2, MEF2C, NRXN1, SATB2, SLC9A6, STXBP1, TBL1XR1, TCF4, UBE3A, WDR45, ZEB2
  • Molecular confirmation of a clinical diagnosis
  • To assist with decisions about treatment and management of individuals with epilepsy
  • Testing of at-risk relatives for specific known mutation(s) previously identified in an affected family member
  • Prenatal diagnosis for known familial variant(s) in at-risk pregnancies
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

729
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81405x2, 81406x2, 81302x1, 81304x1, 81404x1
Yes
Yes
  • 315.3 Developmental speech or language disorder
  • 345.9 Epilepsy, unspecified [0-1] Epileptic convulsions, fits, or seizures NOS Recurrent seizures NOS Seizure disorder NOS Excludes: convulsion (convulsive) disorder (780.39) convulsive seizure or fit NOS (780.39) recurrent convulsions (780.39)
  • 299 Pervasive developmental disorders
  • 315.9 Unspecified delay in development, Developmental disorder NOS, Learning disorder NOS
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
MECP2 Gene Sequencing & Del/Dup

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Confirmation of clinical diagnosis
  • Differentiation between de novo and familial cases
  • Prenatal diagnosis in at-risk pregnancies
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

549
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81302x1, 81304x1
No
Yes
  • 315.3 Developmental speech or language disorder
  • 299 Pervasive developmental disorders
  • 299 Pervasive developmental disorders
  • 315.9 Unspecified delay in development, Developmental disorder NOS, Learning disorder NOS
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Zeev et al. J Child Neurol 17:20-24, 2002
  2. del Gaudio et al. Gene Med 8:784-792, 2006
  3. Van Esch H. et al. Am J Hum Genet 77,:442-453, 2005
  4. Neul et al. Neurology 70:1313-1321, 2008
  5. Bebbington et al. Neurology 70:868-875, 2008
  6. Debona et al. Eur J Hum Genet 8:325-330, 2000
  7. Hitchins et al. Am J Med Genet A 125:167-172, 2004
  8. Couvert et al. Hum Mol Genet 10:941-946, 2001
  9. Kleefstra et al. Eur J Hum Genet 12:24-28, 2004
  10. Abdul-Rahman et al. Genet Med 8:50-54, 2006
  11. Carney et al. Pediatr Neurol 28:205-211, 2003
  12. Villard. J Med Genet 44:417-423, 2007, Bunyan et al. Genet Test 12:373-376, 2008
Prader-Willi Syndrome Methylation Analysis

Forms and Documents

Test Requisition Test Info Sheet

Test Details

  • Confirmation of clinical diagnosis
  • Targeted testing for a known familial deletion, UPD or imprinting error
  • Prenatal diagnosis by targeted array CGH for deletions or UPD only (methylation analysis not available for prenatal).
  • MLPA

Ordering

595
3-4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81331x1
Yes
Yes
  • 315.3 Developmental speech or language disorder
  • 759.8 Other specified anomalies
  • 315.9 Unspecified delay in development, Developmental disorder NOS, Learning disorder NOS
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Jin, D.K. et al. (2011) Korean J Pediatr, 54(2):55-63.
  2. Whittington, J. et al. (2010) Am J Med Genet, 154C:438-447.
  3. Dykens, E. & Shah, B. (2003) CNS Drugs, 17(3):167-178.
  4. Milner, K. et al. (2005) J Child Psychol Psyc, 46(10):1089-1096.
  5. Chai, J-H. et al. (2003) Am J Hum Genet, 73:898-925.
  6. Veltman, M. et al. (2005) Psych Genet, 15:243-254.
  7. Bittel, D.C. et al. (2006) Pediatrics, 118(4):e1276-1283.
  8. Buiting, K. et al. (2003) Am J Hum Genet, 72:571-577.
  9. Holm, V. et al. (1993) Pediatrics, 91:398-402.
  10. Gunay-Aygun, M. et al. (2001) Pediatrics, 108(5):e92.
  11. Cassidy, S. and Schwartz, S. (Updated September 3, 2009). Prader-Willi Syndrome. In: GeneReviews at GeneTests: Medical Genetics Information Resource (database online). Copyright, University of Washington, Seattle. 1993-. Available at http://www.genetests.
Angelman Syndrome Methylation Analysis

Forms and Documents

Test Requisition Test Info Sheet

Test Details

  • Confirmation of clinical diagnosis
  • Targeted testing for a known familial deletion, UPD or imprinting error
  • Prenatal diagnosis by targeted array CGH for deletions or UPD only (methylation analysis not available for prenatal)
  • MLPA

Ordering

566
3-4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81331x1
Yes
Yes
  • 315.3 Developmental speech or language disorder
  • 315.9 Unspecified delay in development, Developmental disorder NOS, Learning disorder NOS
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Piard et al., (2011) Am J Med Genet 155:3170-3173.
  2. Beleza-Meireles et al., (2011) Eur J Med Genet 54:348-350.
  3. Boyes L., et al. Eur J Med Genet. (2006) 49(6):472-80.
  4. Hu et al., (2009) HUGO J 3:41-49.
  5. Whibley et al., (2010) Am J Hum Genet 87:173-188.
  6. Schroer R., et al. Am J Med Genet. (2009) 152A:2775-2783.
  7. Russo, S., et al, (2000) Hum Mutan 15(4):387-393.
  8. Clayton-Smith, J., et al (2003) J Med Genet 40(2):87-95.
  9. Fang, P., et al, (1991) Hum Molec Genet 8(1):129-135.
  10. Malzac, P., et al, (1998) Am J Hum Genet 62(6):1353-1360.
  11. Gillfillan G et al., Am. J. Hum. Genet. 82(4): 1003-1010, 2008.
  12. Christianson A et al. Am J. Hum Genet. 36:759-766, 1999.
  13. Williams, C.A. and Dagli A.I. (Updated June 16, 2011). Angelman Syndrome. In: GeneReviews at GeneTests: Medical Genetics Information Resource (database online). Copyright, University of Washington, Seattle. 1997-2009. Available at http://www.genetests.org
  14. Lossie, A.C., et al, (2001) J Med Genet 38(12):834-845.
  15. Hitchins, M.P., et al, (2004) Am J Med Genet 125A(2):167-172.
  16. Dagli AI.,et al, (2015) GeneReviews
UBE3A Gene Sequencing & Del/Dup

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Confirmation of clinical diagnosis
  • Targeted testing for a known familial mutation
  • Prenatal diagnosis in at risk pregnancies
  • Capillary Sequencing
  • ExonArray CGH

Ordering

546
6-7 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81406x1, 81479x1
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Boyes L., et al. Eur J Med Genet. (2006) 49(6):472-80
  2. Fichou et al. European Journal of Human Genetics (2009) 17, 1378–1380
  3. Clayton-Smith, J., et al (2003) J Med Genet 40(2):87-95
  4. Russo, S., et al, (2000) Hum Mutan 15(4):387-393
  5. Fang, P., et al, (1991) Hum Molec Genet 8(1):129-135
  6. Hitchins, M.P., et al, (2004) Am J Med Genet 125A(2):167-172
  7. Lossie, A.C., et al, (2001) J Med Genet 38(12):834-845
  8. Dagli AI, Mueller J, Williams CA. Angelman Syndrome. 1998 Sep 15 [Updated 2015 May 14]. In: Pagon RA, Adam MP, Ardinger HH, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2017.
  9. Malzac, P., et al, (1998) Am J Hum Genet 62(6):1353-1360
  10. Gillfillan G et al., Am. J. Hum. Genet. 82(4): 1003- 1010, 2008
  11. Christianson A et al. Am J. Hum Genet. 36:759-766, 1999
  12. Schroer R., et al. Am J Med Genet. (2009) 152A:2775-2783
Comprehensive Epilepsy Panel

Forms and Documents

Test Info Sheet Test Requisition Epilepsy Guide Letter of Medical Necessity

Test Details

ADSL, ALDH5A1, ALDH7A1, ALG13, ARHGEF9, ARX, ASNS, ATP1A2, ATP1A3, ATP6AP2, ATRX, BRAT1, CACNA1A, CASK, CDKL5, CHD2, CHRNA2, CHRNA4, CHRNA7, CHRNB2, CLCN4, CLN3, CLN5, CLN6, CLN8, CNTNAP2, CSTB, CTNNB1, CTSD, CTSF, DDX3X, DEPDC5, DNAJC5, DNM1, DYRK1A, EEF1A2, EHMT1, EPM2A, FLNA, FOLR1, FOXG1, FRRS1L, GABBR2, GABRA1, GABRB2, GABRB3, GABRG2, GAMT, GATM, GLDC, GNAO1, GOSR2, GRIN1, GRIN2A, GRIN2B, HNRNPU, IQSEC2, KANSL1, KCNA2, KCNB1, KCNC1, KCNH1, KCNJ10, KCNMA1, KCNQ2, KCNQ3, KCNT1, KCTD7, KDM6A, KIAA2022, LGI1, MAGI2, MBD5, MECP2, MEF2C, MFSD8, NALCN, NGLY1, NHLRC1, NPRL3, NR2F1, NRXN1, PACS1, PCDH19, PIGA, PIGN, PIGO, PIGV, PLCB1, PNKP, PNPO, POLG, PPP2R5D, PPT1, PRRT2, PURA, QARS, SATB2, SCARB2, SCN1A, SCN1B, SCN2A, SCN8A, SLC13A5, SLC19A3, SLC25A22, SLC2A1, SLC6A1, SLC6A8, SLC9A6, SMC1A, SPATA5, SPTAN1, STX1B, STXBP1, SYNGAP1, SZT2, TBC1D24, TBL1XR1, TCF4, TPP1, TSC1, TSC2, UBE3A, WDR45, WWOX, ZEB2
  • Molecular confirmation of a clinical diagnosis
  • To assist with decisions about treatment and management of individuals with epilepsy
  • Testing of at-risk relatives for specific known mutation(s) previously identified in an affected family member
  • Prenatal diagnosis for known familial mutation(s) in at-risk pregnancies
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

523
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81403x1, 81189x1, 81404x4, 81405x2, 81406x2, 81407x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
STAT Epilepsy Panel

Forms and Documents

Test Requisition Test Info Sheet Letter of Medical Necessity

Test Details

ALDH7A1, ARX, BRAT1, CDKL5, FOLR1, GLDC, KCNQ2, KCNQ3, KCNT1, MECP2, MEF2C, PCDH19, PNPO, POLG, SCN1A, SCN1B, SCN2A, SCN8A, SLC19A3, SLC2A1, SLC6A8, SPTAN1, STXBP1, TPP1, TSC1, TSC2
  • Molecular confirmation of a clinical diagnosis
  • To assist with decisions about treatment and management of individuals with epilepsy
  • Testing of at-risk relatives for specific known mutation(s) previously identified in an affected family member
  • Prenatal diagnosis for known familial mutation(s) in at-risk pregnancies
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

814
2 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81404x2, 81405x2, 81406x2, 81407x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Infantile Epilepsy Panel

Forms and Documents

Test Requisition Epilepsy Guide Test Info Sheet Letter of Medical Necessity

Test Details

ADSL, ALDH5A1, ALDH7A1, ALG13, ARHGEF9, ARX, ASNS, ATP1A3, ATP6AP2, ATRX, BRAT1, CACNA1A, CASK, CDKL5, CHD2, CHRNA7, CLCN4, CLN3, CLN5, CLN6, CLN8, CNTNAP2, CTSD, DDX3X, DEPDC5, DNM1, DYRK1A, EEF1A2, EHMT1, FOLR1, FOXG1, FRRS1L, GABBR2, GABRA1, GABRB2, GABRB3, GABRG2, GAMT, GATM, GLDC, GNAO1, GRIN1, GRIN2A, GRIN2B, HNRNPU, IQSEC2, KANSL1, KCNA2, KCNB1, KCNH1, KCNJ10, KCNMA1, KCNQ2, KCNQ3, KCNT1, KCTD7, KDM6A, KIAA2022, MAGI2, MBD5, MECP2, MEF2C, MFSD8, NALCN, NGLY1, NPRL3, NR2F1, NRXN1, PACS1, PCDH19, PIGA, PIGN, PIGO, PIGV, PLCB1, PNKP, PNPO, POLG, PPP2R5D, PPT1, PRRT2, PURA, QARS, SCN1A, SCN1B, SCN2A, SCN8A, SLC13A5, SLC19A3, SLC25A22, SLC2A1, SLC6A1, SLC6A8, SLC9A6, SMC1A, SPATA5, SPTAN1, STX1B, STXBP1, SYNGAP1, SZT2, TBC1D24, TBL1XR1, TCF4, TPP1, TSC1, TSC2, UBE3A, WDR45, WWOX, ZEB2
  • Molecular confirmation of a clinical diagnosis
  • To assist with decisions about treatment and management of individuals with epilepsy
  • Testing of at-risk relatives for specific known mutation(s) previously identified in an affected family member
  • Prenatal diagnosis for known familial mutation(s) in at-risk pregnancies
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

541
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81185x1, 81404x2, 81405x2, 81406x2, 81407x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Childhood-Onset Epilepsy Panel

Forms and Documents

Test Requisition Epilepsy Guide Test Info Sheet Letter of Medical Necessity

Test Details

ADSL, ALDH5A1, ATP1A3, ATRX, CACNA1A, CASK, CDKL5, CHD2, CHRNA2, CHRNA4, CHRNA7, CHRNB2, CLCN4, CLN3, CLN5, CLN6, CLN8, CNTNAP2, CSTB, CTSD, DDX3X, DEPDC5, DYRK1A, EEF1A2, EHMT1, EPM2A, FOLR1, FOXG1, GABRA1, GABRB2, GABRB3, GABRG2, GAMT, GATM, GNAO1, GOSR2, GRIN1, GRIN2A, IQSEC2, KANSL1, KCNA2, KCNC1, KCNMA1, KCNT1, KCTD7, KDM6A, KIAA2022, LGI1, MAGI2, MBD5, MECP2, MEF2C, MFSD8, NALCN, NGLY1, NHLRC1, NPRL3, NRXN1, PACS1, PCDH19, PIGN, PNKP, POLG, PPP2R5D, PPT1, PURA, SCN1A, SCN1B, SCN2A, SLC19A3, SLC2A1, SLC6A1, SLC6A8, SLC9A6, SMC1A, SPATA5, STX1B, SYNGAP1, TBC1D24, TCF4, TPP1, UBE3A, WDR45, ZEB2
  • Molecular confirmation of a clinical diagnosis
  • To assist with decisions about treatment and management of individuals with epilepsy
  • Testing of at-risk relatives for specific known mutation(s) previously identified in an affected family member
  • Prenatal diagnosis for known familial mutation(s) in at-risk pregnancies
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

542
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81189x1, 81404x1, 81405x2, 81406x2 , 81407x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Progressive Myoclonic Epilepsy Panel

Forms and Documents

Test Requisition Epilepsy Guide Test Info Sheet Letter of Medical Necessity

Test Details

CLN3, CLN5, CLN6, CLN8, CSTB, CTSD, CTSF, DNAJC5, EPM2A, FOLR1, GOSR2, KCNC1, KCTD7, MFSD8, NHLRC1, PPT1, SCARB2, TPP1
  • Molecular confirmation of a clinical diagnosis
  • To assist with decisions about treatment and management of individuals with epilepsy
  • Testing of at-risk relatives for specific known mutation(s) previously identified in an affected family member
  • Prenatal diagnosis for known familial mutation(s) in at-risk pregnancies
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

544
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81189x1, 81403x1, 81404x1, 81479x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
EpiXpanded Panel

Forms and Documents

Test Requisition Test Info Sheet Gene List Family Member Test Requisition

Test Details

AAAS, AARS, AARS2, AASS, ABAT, ABCA5, ABCA7, ABCB7, ABCC8, ABCC9, ABCD1, ABCD3, ACAD9, ACADM, ACADS, ACADSB, ACMSD, ACO2, ACOT7, ACOX1, ACSF3, ACSL4, ACTB, ACTG1, ACTL6B, ACVR1, ACVRL1, ACY1, ADAM22, ADAR, ADAT3, ADCK3, ADCK4, ADD3, ADGRG1, ADK, ADNP, ADRA2B, ADSL, AFF2, AFG3L2, AGA, AGGF1, AGK, AGTR2, AHI1, AHSG, AIFM1, AIMP1, AIMP2, AKT1, AKT2, AKT3, ALAD, ALDH18A1, ALDH1B1, ALDH3A2, ALDH4A1, ALDH5A1, ALDH7A1, ALDOB, ALG1, ALG11, ALG12, ALG13, ALG2, ALG3, ALG6, ALG8, ALG9, ALMS1, ALPL, ALX4, AMACR, AMER1, AMPD2, AMT, ANK2, ANK3, ANKH, ANKLE2, ANKRD11, ANO10, ANO3, AP1S2, AP3B2, AP3D1, AP4B1, AP4E1, AP4M1, AP4S1, APC2, APOA1BP, APOPT1, APTX, AQP2, ARCN1, ARFGEF2, ARG1, ARHGAP31, ARHGEF15, ARHGEF6, ARHGEF9, ARID1A, ARID1B, ARID2, ARL13B, ARMC9, ARNT2, ARSA, ARV1, ARVCF, ARX, ASAH1, ASCL1, ASL, ASNS, ASPA, ASPM, ASS1, ASTN1, ASTN2, ASXL1, ASXL2, ASXL3, ATAD1, ATAD3A, ATIC, ATN1, ATP13A2, ATP1A2, ATP1A3, ATP2A2, ATP2B3, ATP5A1, ATP5E, ATP6AP1, ATP6AP2, ATP6V0A2, ATP6V0C, ATP6V1A, ATP6V1B2, ATP7A, ATP8A2, ATPAF2, ATR, ATRIP, ATRX, ATXN10, AUH, AUTS2, AVPR2, B3GALNT2, B3GALTL, B4GALT1, B4GAT1, B9D1, BCAP31, BCKDHA, BCKDHB, BCKDK, BCL11A, BCL11B, BCOR, BCR, BCS1L, BDNF, BMP2, BMP4, BOLA3, BRAF, BRAT1, BRCC3, BRD4, BRWD3, BSCL2, BSN, BTD, BUB1, BUB1B, BUB3, C10orf2, C12ORF57, C12ORF65, C5orf42, CA8, CACNA1A, CACNA1C, CACNA1D, CACNA1E, CACNA1G, CACNA1H, CACNA2D1, CACNA2D2, CACNB4, CACNG2, CAD, CALM1, CALM2, CALM3, CAMK2A, CAMK2B, CAMKMT, CAMTA1, CARD9, CARS2, CASK, CBL, CBS, CC2D1A, CC2D2A, CCBE1, CCDC115, CCDC88A, CCDC88C, CCM2, CCND2, CCR1, CD96, CDC42, CDH11, CDH15, CDK10, CDK5RAP2, CDK6, CDKL5, CDON, CECR1, CELF4, CENPE, CENPJ, CEP104, CEP120, CEP135, CEP152, CEP164, CEP290, CEP41, CEP57, CEP63, CERS1, CHAT, CHD2, CHD4, CHD7, CHD8, CHKB, CHL1, CHRNA2, CHRNA4, CHRNA7, CHRNB2, CIC, CIT, CKAP2L, CLCF1, CLCN2, CLCN4, CLCNKA, CLCNKB, CLDN16, CLEC7A, CLIC2, CLIP1, CLMP, CLN3, CLN5, CLN6, CLN8, CLP1, CLPB, CLPP, CLTC, CNKSR2, CNNM2, CNPY3, CNTN2, CNTN4, CNTNAP2, COA3, COA5, COA7, COG1, COG2, COG4, COG5, COG6, COG7, COG8, COL13A1, COL18A1, COL25A1, COL4A1, COL4A2, COL4A3BP, COMT, COPB2, COQ2, COQ4, COQ6, COQ9, COX10, COX14, COX15, COX20, COX6B1, COX7B, COX8A, CPA6, CPLX1, CPOX, CPS1, CPT1A, CPT2, CRADD, CRB2, CRBN, CREBBP, CRH, CRHR1, CRKL, CRLF1, CSF1R, CSMD1, CSNK2A1, CSNK2B, CSPP1, CSTB, CTBP1, CTC1, CTLA4, CTNNB1, CTNND2, CTR9, CTSA, CTSD, CTSF, CUL4B, CXCR4, CYC1, CYFIP2, CYP27A1, CYP27B1, CYP2C9, CYP2R1, CYP2U1, D2HGDH, DAG1, DARS2, DBH, DBT, DCC, DCHS1, DCX, DDC, DDOST, DDX3X, DEAF1, DENND5A, DEPDC5, DGKD, DGUOK, DHCR24, DHCR7, DHDDS, DHFR, DHX30, DIAPH1, DIP2B, DIS3L2, DISP1, DLAT, DLD, DLG1, DLG2, DLG3, DLG4, DLGAP2, DLL1, DLL4, DMBX1, DMD, DNA2, DNAJC19, DNAJC5, DNAJC6, DNASE1L3, DNM1, DNM1L, DNMT3A, DOCK6, DOCK7, DOLK, DPAGT1, DPM1, DPM2, DPM3, DPYD, DPYS, DUSP6, DYNC1H1, DYRK1A, EARS2, EBP, ECE1, ECHS1, ECM1, EDC3, EEF1A2, EFHC1, EFHC2, EFTUD2, EGF, EHHADH, EHMT1, EIF2AK3, EIF2B1, EIF2B2, EIF2B3, EIF2B4, EIF2B5, EIF2S3, ELMO2, ELOVL4, ELP4, EMC1, EMG1, EML1, EMX2, ENG, EOGT, EP300, EPB41L1, EPG5, EPM2A, EPT1, ERBB4, ERCC1, ERCC2, ERCC3, ERCC4, ERCC5, ERCC6, ERCC8, ERF, ERLIN2, ERMARD, ESCO2, ETFA, ETFB, ETFDH, ETHE1, EXOC6B, EXOSC3, EXOSC8, EXT2, EXTL3, EZH2, FA2H, FADD, FAM111A, FAM126A, FAM58A, FAR1, FARS2, FAS, FASN, FASTKD2, FAT4, FBP1, FBXL4, FBXO28, FBXO31, FDXR, FGD1, FGF12, FGF13, FGF17, FGF23, FGF8, FGFR1, FGFR2, FGFR3, FGFRL1, FH, FHL1, FIG4, FKRP, FKTN, FLI1, FLII, FLNA, FLRT3, FLVCR1, FLVCR2, FMN2, FMR1, FOLR1, FOXG1, FOXH1, FOXP1, FOXRED1, FRG1, FRMPD4, FRRS1L, FTO, FTSJ1, FUCA1 , FXYD2, G6PC, GAA, GABBR2, GABRA1, GABRA3, GABRA5, GABRA6, GABRB1, GABRB2, GABRB3, GABRD, GABRE, GABRG2, GABRG3, GABRQ, GABRR1, GABRR3, GAD1, GAL, GALC, GAMT, GAS1, GATA3, GATA6, GATAD2B, GATM, GBA, GCDH, GCH1, GCM2, GCSH, GDF2, GDI1, GDNF, GFAP, GFER, GFM1, GFM2, GJA1, GJC2, GK, GLB1, GLDC, GLI2, GLI3, GLRA1, GLRB, GLRX5, GLUD1, GLUL, GLYCTK, GM2A, GMPPA, GMPPB, GNA11, GNAI1, GNAO1, GNAQ, GNAS, GNB1, GNB5, GNE, GNPTAB, GNPTG, GNRH1, GNS, GOLGA2, GOSR2, GP1BB, GPAA1, GPC3, GPC4, GPHN, GPR161, GPSM2, GPT2, GRIA3, GRIA4, GRIK2, GRIN1, GRIN2A, GRIN2B, GRIN2D, GRIP1, GRM1, GRM7, GRM8, GRN, GSPT2, GSS, GTPBP3, GUCY1A3, GUF1, GUSB, GYS1, GYS2, HACE1, HADH, HARS2, HAX1, HCCS, HCFC1, HCN1, HCN2, HDAC1, HDAC4, HDAC8, HECW2, HEPACAM, HERC1, HERC2, HESX1, HEXA, HEXB, HGSNAT, HIBCH, HIC1, HIP1, HIRA, HIVEP2, HK1, HLA-B, HLA-DPB1, HLCS, HMBS, HMGCL, HMGCS2, HNRNPH2, HNRNPL, HNRNPU, HPD, HRAS, HSD17B10, HSD17B4, HSPD1, HTR1A, HUWE1, HYLS1, IARS, IBA57, ICK, IDH2, IDS, IDUA, IER3IP1, IFIH1, IFT140, IL10, IL12A, IL12B, IL12RB2, IL17F, IL17RA, IL1RAPL1, IL23R, IL27RA, IMPAD1, INO80, INPP4A, INPP5E, INPP5K, INS, INSR, INVS, IQCB1, IQSEC1, IQSEC2, IRF2BPL, ISCU, ISPD, ITGB6, ITPA, ITPR1, IVD, JAM3, JMJD1C, JRK, KANK1, KANSL1, KARS, KAT6A, KAT6B, KATNB1, KCNA1, KCNA2, KCNAB1, KCNAB2, KCNB1, KCNC1, KCNC3, KCND2, KCND3, KCNH1, KCNJ1, KCNJ10, KCNJ11, KCNJ13, KCNJ2, KCNJ6, KCNMA1, KCNQ2, KCNQ3, KCNQ5, KCNT1, KCNT2, KCNV2, KCTD3, KCTD7, KDM2B, KDM5B, KDM5C, KDM6A, KIAA0226, KIAA0556, KIAA0586, KIAA0753, KIAA1033, KIAA1279, KIAA1715, KIAA2022, KIF11, KIF1A, KIF2A, KIF4A, KIF5A, KIF5C, KIF7, KIRREL3, KISS1, KLF13, KLHL15, KLHL7, KLLN, KLRC4, KMT2A, KMT2D, KPNA7, KPTN, KRAS, KRIT1, KRT83, L1CAM, L2HGDH, LAGE3, LAMA2, LAMB1, LAMC3, LARGE, LARS, LARS2, LAS1L, LBR, LETM1, LGI1, LGI4, LHX1, LIAS, LIG4, LIPT1, LMAN2L, LMBRD1, LMNB2, LONP1, LRFN2, LRP2, LRPPRC, LYRM7, LYST, MAF, MAFB, MAGEL2, MAGI2, MAGT1, MAN1B1, MANBA, MAOA, MAP2K1, MAP2K2, MAPK1, MAPK10, MAPK3, MAPRE2, MAPT, MARS2, MATN4, MBD5, MBOAT7, MBTPS2, MC2R, MCCC1, MCCC2, MCEE, MCM4, MCOLN1, MCPH1, MCTP2, MDH2, ME2, MECP2, MED12, MED13L, MED17, MED23, MED25, MEF2C, MEFV, MEGF10, MEIS2, METTL23, MFF, MFSD2A, MFSD8, MGAT2, MGME1, MGP, MICAL1, MID2, MIPEP, MKS1, MLC1, MLLT3, MLX, MLYCD, MMAA, MMACHC, MMADHC, MN1, MOCS1, MOCS2, MOGS, MPC1, MPDU1, MPDZ, MPP7, MPV17, MRAP, MRI1, MRPL44, MRPS16, MRPS22, MSX2, MTFMT, MTM1, MTO1, MTOR, MTPAP, MTR, MTRR, MUT, MVK, MYH1, MYH3, MYO5A, MYO7B, MYO9A, MYOCD, MYT1L, NAA10, NACC1, NADK2, NAGA, NAGLU, NAGS, NALCN, NANS, NARS2, NAT8L, NBAS, NBEA, NDE1, NDN, NDP, NDST1, NDUFA1, NDUFA10, NDUFA11, NDUFA12, NDUFA13, NDUFA2, NDUFA4, NDUFA9, NDUFAF1, NDUFAF2, NDUFAF3, NDUFAF4, NDUFAF5, NDUFAF6, NDUFB11, NDUFB3, NDUFB9, NDUFS1, NDUFS2, NDUFS3, NDUFS4, NDUFS6, NDUFS7, NDUFS8, NDUFV1, NDUFV2, NECAP1, NEDD4L, NEK9, NELFA, NEU1, NEUROD2, NF1, NFIA, NFIX, NFU1, NGLY1, NHEJ1, NHLRC1, NID1, NIN, NIPA1, NIPA2, NIPBL, NLGN1, NLGN4X, NMNAT1, NNT, NODAL, NOL3, NONO, NOTCH3, NPAP1, NPC1, NPC2, NPHP1, NPHP3, NPHP4, NPRL2, NPRL3, NR2F1, NRAS, NRXN1, NRXN3, NSD1, NSDHL, NSUN2, NTNG1, NTRK2, NUBPL, NUP107, NUS1, OCLN, OCRL, OFD1, OGT, OPA1, OPA3, OPHN1, OSGEP, OTC, OTUD6B, OTX2, PACS1, PACS2, PAFAH1B1, PAH, PAK3, PANK2, PARK2, PARS2, PAX2, PAX6, PC, PCCA, PCCB, PCDH12, PCDH19, PCDH7, PCDHB4, PCK1, PCLO, PCNT, PDCD10, PDE10A, PDE4D, PDE6D, PDGFB, PDGFRB, PDHA1, PDHB, PDHX, PDP1, PDSS1, PDSS2, PDYN, PET100, PEX1, PEX10, PEX11B, PEX12, PEX13, PEX14, PEX16, PEX19, PEX2, PEX26, PEX3, PEX5, PEX6, PEX7, PGAP1, PGAP2, PGAP3, PGK1, PGM1, PHC1, PHF21A, PHF6, PHGDH, PHOX2B, PI4KA, PIBF1, PIEZO2, PIGA, PIGC, PIGG, PIGL, PIGM, PIGN, PIGO, PIGP, PIGQ, PIGS, PIGT, PIGV, PIGW, PIGY, PIK3AP1, PIK3CA, PIK3R2, PLA2G6, PLAA, PLAGL1, PLCB1, PLEKHG2, PLK4, PLP1, PLXND1, PMM2, PMPCA, PNKD, PNKP, PNPLA8, PNPO, PNPT1, PODXL, POGZ, POLA1, POLG, POLG2, POLR3A, POLR3B, POMGNT1, POMGNT2, POMK, POMT1, POMT2, POU1F1, PPM1B, PPM1K, PPOX, PPP1R15B, PPP1R3C, PPP2R1A, PPP2R5D, PPP3CA, PPT1, PQBP1, PRDM8, PRDX1, PREPL, PRF1, PRICKLE1, PRICKLE2, PRIMA1, PRKAR1A, PRKDC, PRMT7, PRODH, PROP1, PROSC, PRPS1, PRRT2, PRSS12, PRTN3, PRUNE, PSAP, PSAT1, PSPH, PTCH1, PTCHD1, PTEN, PTF1A, PTH, PTPN11, PTPN22, PTPN23, PTPRD, PTS, PUM1, PURA, PUS1, PVRL1, PYCR2, QARS, QDPR, RAB11A, RAB18, RAB27A, RAB39B, RAB3GAP1, RAB3GAP2, RAC1, RAD21, RAF1, RAI1, RANBP2, RAP1A, RAP1B, RARS2, RBBP8, RBFOX1, RBFOX3, RBM10, RBM8A, RBPJ, RECQL4, REEP1, RELN, RERE, RFT1, RHOBTB2, RILP, RLBP1, RMND1, RNASEH2A, RNASEH2B, RNASEH2C, RNASET2, RNF125, ROBO1, ROBO3, ROGDI, RORA, RORB, RPGRIP1L, RPIA, RPL10, RPS6KA3, RREB1, RRM2B, RTN4IP1, RTTN, RYR2, RYR3, SACS, SAMD9, SAMHD1, SARS2, SASS6, SATB2, SC5D, SCARB2, SCN10A, SCN11A, SCN1A, SCN1B, SCN2A, SCN3A, SCN3B, SCN7A, SCN8A, SCN9A, SCNM1, SCO1, SCO2, SDCCAG8, SDHA, SDHAF1, SEC24C, SEC24D, SEPSECS, SERAC1, SERPINI1, SETBP1, SETD1A, SETD1B, SETD2, SETD5, SGCE, SGSH, SH2B1, SHANK1, SHANK3, SHH, SHOC2, SHROOM4, SIK1, SIN3A, SIX3, SKI, SLC12A1, SLC12A2, SLC12A3, SLC12A5, SLC12A6, SLC13A5, SLC16A1, SLC16A2, SLC17A5 , SLC18A2, SLC19A2, SLC19A3, SLC1A1, SLC1A2, SLC1A3, SLC1A4, SLC20A2, SLC25A1, SLC25A10, SLC25A12, SLC25A15, SLC25A19, SLC25A20, SLC25A22, SLC25A3, SLC25A4, SLC26A1, SLC2A1, SLC33A1, SLC35A1, SLC35A2, SLC35A3, SLC35C1, SLC37A4, SLC39A8, SLC45A1, SLC46A1, SLC4A10, SLC5A7, SLC6A1, SLC6A17, SLC6A19, SLC6A5, SLC6A8, SLC9A1, SLC9A6, SLC9A9, SMAD2, SMAD4, SMARCA2, SMARCA4, SMARCB1, SMARCE1, SMC1A, SMC3, SMCHD1, SMG9, SMPD1, SMS, SNAP25, SNAP29, SNIP1, SNRPN, SNX10, SNX14, SNX27, SON, SOS1, SOX10, SOX11, SOX17, SOX2, SOX3, SOX5, SPAST, SPATA5, SPG11, SPG7, SPINK5, SPR, SPRED1, SPRY4, SPTAN1, SQSTM1, SRCAP, SRD5A3, SRPX2, SSR4, SSTR5, ST3GAL3, ST3GAL5, ST5, ST7, ST8SIA2, STAMBP, STAR, STARD9, STX11, STX16, STX1B, STXBP1, STXBP2, STYXL1, SUCLA2, SUCLG1, SUCO, SUFU, SUMF1, SUOX, SURF1, SV2A, SYN1, SYN2, SYNGAP1, SYNJ1, SYP, SYT14, SYT2, SZT2, TAC3, TACO1, TACR3, TAF1, TANGO2, TAT, TAZ, TBC1D20, TBC1D24, TBCD, TBCE, TBCK, TBL1XR1, TBR1, TBX1, TBX18, TBX19, TCF4, TCIRG1, TCTN1, TCTN2, TCTN3, TDGF1, TDP2, TECPR2, TECR, TFAP2A, TGDS, TGIF1, TH, THAP11, TIMM50, TIMM8A, TIMMDC1, TK2, TMEM106B, TMEM126A, TMEM126B, TMEM138, TMEM165, TMEM216, TMEM231, TMEM237, TMEM5, TMEM67, TMEM70, TMLHE, TMTC3, TOE1, TP53RK, TPK1, TPP1, TPRKB, TRAF3IP1, TRAF3IP2, TRAPPC11, TRAPPC6B, TRAPPC9, TREM2, TREX1, TRIM8, TRIO, TRIP13, TRIT1, TRMT10A, TRNT1, TRPM6, TRPS1, TSC1, TSC2, TSEN15, TSEN2, TSEN34, TSEN54, TSFM, TSPAN7, TTC19, TUBA1A, TUBA3E, TUBA8, TUBB2A, TUBB2B, TUBB3, TUBB4A, TUBG1, TUBGCP4, TUBGCP6, TUFM, TUSC3, TWIST1, TXN2, TYMP, TYROBP, UBA5, UBAC2, UBB, UBE2A, UBE3A, UBTF, UCP2, UFD1L, UGDH, UMPS, UNC13D, UNC80, UPB1, UPF3B, UQCC2, UQCC3, UQCRB, UQCRC2, UQCRQ, USP18, USP9X, VANGL1, VARS, VARS2, VCP, VDR, VLDLR, VPS11, VPS13A, VPS13B, VPS53, VRK1, WAC, WARS2, WDR19, WDR26, WDR45, WDR45B, WDR62, WDR73, WDR81, WFS1, WHSC1, WWOX, XK, XPA, XPC, XPNPEP3, XPR1, XRCC1, YAP1, YARS2, YWHAE, YWHAG, ZBTB18, ZBTB20, ZC3H14, ZC4H2, ZDHHC15, ZDHHC9, ZEB2, ZFP57, ZFYVE26, ZIC2, ZMYND11, ZMYND12, ZNF335, ZNF41, ZNF423, ZNF592, ZNF674, ZNF711, ZNF81, ZNHIT3, ZSWIM6
  • Molecular confirmation of a clinical diagnosis
  • To assist with decisions about treatment and management of individuals with epilepsy
  • Testing of at-risk relatives for specific known variant(s) previously identified in an affected family member
  • Prenatal diagnosis for known familial pathogenic variant(s) in at-risk pregnancies
  • Next-Gen Sequencing

Ordering

921
6 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81404x4, 81405x2, 81406x2, 81407x1, 81408x2, 81302x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Pong et al. (2011) Pediatric Neurology 44 (5):317-27 (PMID: 21481738)
  2. Dyment et al. (2014) Clinical Genetics : (PMID: 25046240)
  3. Michaud et al. (2014) Human Molecular Genetics 23 (18):4846-58 (PMID: 24781210)
  4. Veeramah et al. (2013) Epilepsia 54 (7):1270-81 (PMID: 23647072)
  5. Allen et al. (2013) Nature 501 (7466):217-21 (PMID: 23934111)
  6. EuroEPINOMICS-RES et al. American Journal Of Human Genetics 95 (4):360-370 (PMID: 25262651)
  7. Lee et al. (2014) Jama 312 (18):1880-7 (PMID: 25326637)
  8. McKnight D, Retterer K, Juusola J, Brandt T, Richard G, and Suchy S, Genetic Testing Strategies for Patients with Epilepsy and Neurodevelopmental Disorders; (Abstract #562). Presented at the 2015 ACMG Annual Clinical Genetics Meeting, March 27, 2015, Salt
Epilepsy Deletion/Duplication Panel

Forms and Documents

Test Requisition Test Info Sheet Letter of Medical Necessity

Test Details

ADSL, ALDH5A1, ALDH7A1, ALG13, ARHGEF9, ARID1B, ARX, ASNS, ATP1A2, ATP1A3, ATP6AP2, ATRX, BRAT1, CACNA1A, CASK, CDKL5, CHD2, CHRNA2, CHRNA4, CHRNA7, CHRNB2, CLCN4, CLN3, CLN5, CLN6, CLN8, CNTNAP2, CREBBP, CSTB, CTNNB1, CTSD, CTSF, DDX3X, DEPDC5, DNAJC5, DYRK1A, EEF1A2, EHMT1, EPM2A, FLNA, FOLR1, FOXG1, FRRS1L, GABBR2, GABRA1, GABRB2, GABRB3, GABRG2, GAMT, GATM, GLDC, GNAO1, GOSR2, GRIN1, GRIN2A, GRIN2B, HNRNPU, IQSEC2, KANSL1, KCNA2, KCNB1, KCNC1, KCNH1, KCNJ10, KCNMA1, KCNQ2, KCNQ3, KCNT1, KCTD7, KDM6A, KIAA2022, LGI1, MAGI2, MBD5, MECP2, MEF2C, MFSD8, NALCN, NGLY1, NHLRC1, NPRL3, NR2F1, NRXN1, OPHN1, PACS1, PCDH19, PHF6, PIGA, PIGN, PIGO, PIGV, PLCB1, PNKP, PNPO, POLG, PPP2R5D, PPT1, PRICKLE1, PRRT2, PURA, QARS, SATB2, SCARB2, SCN1A, SCN1B, SCN2A, SCN8A, SLC13A5, SLC19A3, SLC25A22, SLC2A1, SLC6A1, SLC6A8, SLC9A6, SMC1A, SPATA5, SPTAN1, STX1B, STXBP1, SYNGAP1, SZT2, TBC1D24, TBL1XR1, TCF4, TPP1, TSC1, TSC2, UBE3A, WDR45, WWOX, ZEB2
  • Molecular confirmation of a clinical diagnosis
  • To assist with decisions about treatment and management of individuals with epilepsy
  • Testing of at-risk relatives for specific known variant(s) previously identified in an affected family member
  • Prenatal diagnosis for known familial pathogenic variant(s) in at-risk pregnancies
  • Deletion/Duplication Analysis

Ordering

953
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81304x1, 81403x1, 81405x3, 81406x2
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Hemiplegic Migraine Panel

Forms and Documents

Test Requisition Test Info Sheet Letter of Medical Necessity

Test Details

ATP1A2, CACNA1A, PRRT2, SCN1A
  • Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Assist with treatment/ management decisions
  • Recurrence risk assessment
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

T400
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81185x1, 81406x1, 81479x1
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Tuberous Sclerosis Panel

Forms and Documents

Test Info Sheet Test Requisition Letter of Medical Necessity

Test Details

TSC1, TSC2
  • Confirmation of a clinical diagnosis
  • Carrier testing for individuals with a known familial TSC1 or TSC2 mutation
  • Prenatal diagnosis in at-risk pregnancies
  • Deletion/Duplication Analysis
  • Next-Gen Sequencing

Ordering

730
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81405x1, 81406x2, 81407x1
Yes
Yes
  • 780.39 Other convulsions Convulsive disorder NOS Fits NOS Recurrent convulsions NOS Seizure NOS Seizures NOS
  • 759.5 Tuberous sclerosis Bourneville's disease Epiloia
  • 319 Unspecified mental retardation, Mental deficiency NOS, Mental subnormality NOS
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Northrup H, Koenig MK, Au KS. Tuberous Sclerosis Complex. 1999 Jul 13 [Updated 2015 Sep 3]. In: Pagon RA, Adam MP, Bird TD, et al., editors. GeneReviews™ [Internet].
  2. Roach and Sparagano (2004) J Child Neurol 19:643-649.
  3. Rose et al., (1999) Am J Hum Genet 64:986-992. Qin et al., (2010) Hum Genet 127:573-582.
  4. Mayer et al., (2013) Eur J Hum Genet e1–e4; doi:10.1038/ejhg.2013.129.
  5. Kozlowski et al., (2007) Hum Genet 121:389-400.
  6. Jones et al., (1999) Am J Hum Genet 64:1305-1315.
  7. Dabora et al., (2001) Am J Hum Genet 68:64-80.
  8. Sancak et al., (2005) Eur J Hum Genet 13:731-741.
  9. Au et al., (2007) Genet Med 9:88-100.

CNS Malformations and Disorders

Comprehensive Brain Malformations Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

ACTB, ACTG1, ADGRG1, AHI1, AKT3, AMPD2, ARFGEF2, ARL13B, ARX, ASPM, ATP6V0A2, B3GALNT2, B4GAT1, B9D1, B9D2, C5orf42, CASK, CC2D2A, CCND2, CEP104, CEP120, CEP290, CEP41, CHMP1A, CIT, CSPP1, CUL4B, DCHS1, DCX, DYNC1H1, EXOSC3, FAT4, FKRP, FKTN, FLNA, GMPPB, GPSM2, IFT172, INPP5E, ISPD, KATNB1, KIAA0586, KIF1BP, KIF2A, KIF5C, KIF7, LAMB1, LAMC3, LARGE1, MKS1, NDE1, NEDD4L, NPHP1, NPHP3, OCLN, OFD1, OPHN1, PAFAH1B1, PIK3CA, PIK3R2, POMGNT1, POMGNT2, POMK, POMT1, POMT2, PQBP1, RAB18, RAB3GAP1, RAB3GAP2, RARS2, RELN, RPGRIP1L, RTTN, SEPSECS, SRD5A3, SRPX2, TBC1D20, TCTN1, TCTN2, TCTN3, TMEM138, TMEM216, TMEM231, TMEM237, TMEM5, TMEM67, TSEN15, TSEN2, TSEN34, TSEN54, TTC21B, TUBA1A, TUBA8, TUBB, TUBB2A, TUBB2B, TUBB3, TUBB4A, TUBG1, VLDLR, VPS53, VRK1, WDR62
  • Molecular confirmation of a clinical diagnosis
  • Distinguish between causes and forms of brain malformations
  • Genetic counseling
  • Prenatal diagnosis for known familial mutation(s) in at-risk pregnancies
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

691
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81404x2, 81405x2, 81406x2, 81407x1, 81408x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Cortical Brain Malformations Panel

Forms and Documents

Test Info Sheet Test Requisition

Test Details

ACTB, ACTG1, ADGRG1, AKT3, ARFGEF2, ARX, ASPM, ATP6V0A2, B3GALNT2, B4GAT1, CCND2, CIT, CUL4B, DCHS1, DCX, DYNC1H1, FAT4, FKRP, FKTN, FLNA, GMPPB, GPSM2, ISPD, KATNB1, KIF1BP, KIF2A, KIF5C, LAMB1, LAMC3, LARGE1, NDE1, NEDD4L, OCLN, PAFAH1B1, PIK3CA, PIK3R2, POMGNT1, POMGNT2, POMK, POMT1, POMT2, PQBP1, RAB18, RAB3GAP1, RAB3GAP2, RELN, RTTN, SRD5A3, SRPX2, TBC1D20, TMEM5, TUBA1A, TUBA8, TUBB, TUBB2A, TUBB2B, TUBB3, TUBB4A, TUBG1, VLDLR, WDR62
  • Molecular confirmation of a clinical diagnosis
  • Distinguish between causes and forms of neuronal migration and cortical organization disorders
  • Genetic counseling
  • Prenatal diagnosis for known familial mutation(s) in at-risk pregnancies
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

698
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81404x2, 81405x2, 81406x2, 81407x1
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Pontocerebellar Hypoplasia Panel

Forms and Documents

Test Info Sheet Test Requisition

Test Details

AMPD2, CASK, CHMP1A, EXOSC3, OPHN1, RARS2, RELN, SEPSECS, TSEN15, TSEN2, TSEN34, TSEN54, TUBA1A, TUBA8, TUBB2B, TUBB3, VLDLR, VPS53, VRK1
  • Molecular confirmation of a clinical diagnosis
  • Distinguish between causes and forms of cerebellar hypoplasia
  • Genetic counseling
  • Prenatal diagnosis for known familial mutation(s) in at-risk pregnancies
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

700
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81479x1
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Joubert Syndrome and Related Disorders Panel
Lissencephaly Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

ACTB, ACTG1, ARX, ATP6V0A2, B3GALNT2, B4GAT1, CIT, DCX, FKRP, FKTN, GMPPB, ISPD, KATNB1, LAMB1, LARGE1, NDE1, PAFAH1B1, POMGNT1, POMGNT2, POMT1, POMT2, RELN, TMEM5, TUBA1A, VLDLR, WDR62
  • Molecular confirmation of a clinical diagnosis
  • Distinguish between causes and forms of neuronal migration and cortical organization disorders
  • Genetic counseling
  • Prenatal diagnosis for known familial mutation(s) in at-risk pregnancies
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

946
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81404x2, 81405x2, 81406x2, 81407x1
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Microcephaly Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

AMPD2, ANKLE2, AP4M1, ARFGEF2, ASPM, ASXL1, ATR, ATRX, BRAT1, CASK, CDK5RAP2, CDKL5, CENPE, CENPF, CENPJ, CEP135, CEP152, CIT, CREBBP, CTNNB1, DDX3X, DHCR7, DIAPH1, DYRK1A, EFTUD2, EP300, FOXG1, IER3IP1, KAT6A, KATNB1, KIF11, KIF1A, KMT2D, KNL1, MCPH1, MECP2, MED17, MYCN, NIPBL, PCNT, PNKP, RAB18, RAB3GAP1, RAB3GAP2, RBBP8, RNASEH2C, RTTN, SEPSECS, SLC25A19, SLC9A6, SNAP29, STAMBP, STIL, TCF4, TRAPPC9, TSEN54, TUBA1A, TUBB3, TUBGCP4, TUBGCP6, UBE3A, VPS13B, WDR62, ZEB2, ZNF335
  • Molecular confirmation of a clinical diagnosis
  • Establish the type of microcephaly and cause in order to provide information regarding prognosis, management and recurrence risk.
  • Testing of at-risk relatives for specific known pathogenic variant(s) previously identified in an affected family member
  • Prenatal diagnosis for known familial pathogenic variant(s) in at-risk pregnancies
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

689
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81404x1, 81405x2, 81406x2, 81407x1, 81302x1, 81304x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Microcephaly Xpanded Panel

Forms and Documents

Test Requisition Test Info sheet Gene List Family Member Test Requisition

Test Details

AAAS, AARS, ABCC8, ABCD1, ACADSB, ACD, ACE, ACO2, ACSL4, ACTB, ACTG1, ACTG2, ADAR, ADAT3, ADD3, ADNP, ADSL, AGA, AGGF1, AGMO, AGT, AGTR1, AGTR2, AIMP1, AKT3, ALDH18A1, ALDH3A2, ALDH6A1, ALG1, ALG11, ALG13, ALG3, ALG9, ALX1, ALX4, AMPD2, ANK1, ANKLE2, ANKRD11, AP3B1, AP4B1, AP4E1, AP4M1, AP4S1, APP, ARCN1, ARFGEF2, ARHGAP31, ARHGEF6, ARID1A, ARID1B, ARL14EP, ARNT2, ARSE, ARVCF, ARX, ASNS, ASPM, ASXL1, ASXL3, ATP1A3, ATP2B3, ATP5A1, ATP5E, ATP6V0A2, ATP7A, ATP8A2, ATPAF1, ATPAF2, ATR, ATRIP, ATRX, AUH, AUTS2, B3GALNT2, B3GLCT, B4GAT1, B9D1, B9D2, BAZ1B, BBOX1, BCAP31, BCKDK, BCOR, BCR, BCS1L, BDNF, BLM, BMP15, BMP4, BMPR1A, BRAT1, BRCA2, BRF1, BRIP1, BTG2, BUB1, BUB1B, BUB3, C10orf2, C2CD3, CACNA1H, CACNG2, CANT1, CARS2, CASC5, CASK, CC2D1A, CC2D2A, CCDC88A, CD96, CDC6, CDH15, CDH4, CDK11A, CDK5, CDK5RAP2, CDK6, CDKL5, CDON, CDT1, CENPE, CENPF, CENPJ, CEP135, CEP152, CEP290, CEP57, CEP63, CHAMP1, CHD2, CHD7, CHKB, CHL1, CHMP1A, CHN1, CHRNA1, CHRNA7, CHRND, CHRNG, CHUK, CIT, CKAP2L, CLCN4, CLIP1, CLIP2, CLP1, CLPB, CLPP, CNNM2, CNTN4, COA5, COA6, COG1, COG2, COG4, COG6, COL25A1, COL4A1, COL4A3BP, COLEC11, COMT, COQ9, COX15, COX7B, CPLX1, CPT2, CRADD, CRBN, CREBBP, CRIPT, CRKL, CSNK2A1, CSPP1, CTBP1, CTC1, CTCF, CTNNB1, CTNND2, CTSD, CUL4B, CYB5R3, DAG1, DARS, DCPS, DCX, DDB2, DDX11, DDX3X, DEAF1, DGCR2, DGCR6, DGCR8, DGUOK, DHCR24, DHCR7, DHFR, DHTKD1, DHX37, DIAPH1, DISP1, DKC1, DLAT, DLD, DLG3, DLL1, DLL3, DLL4, DMD, DNA2, DNM1, DNM1L, DOCK6, DOCK8, DOLK, DPAGT1, DPM1, DPM2, DPP6, DPYD, DSTYK, DUSP22, DYM, DYNC1H1, DYRK1A, EDC3, EEF1A2, EFEMP2, EFNB1, EFTUD2, EGF, EHMT1, EIF2AK3, EIF2B1, EIF2B2, EIF2B3, EIF2B4, EIF2B5, ELAC2, ELN, ELOVL4, EMG1, EML1, ENTPD1, EOGT, EOMES, EP300, EPB41L1, EPG5, ERCC1, ERCC2, ERCC3, ERCC4, ERCC5, ERCC6, ERCC6L2, ERCC8, ERMARD, ESCO2, ETFA, EXOSC3, EXOSC8, EXT1, FAM20C, FAM222A, FANCA, FANCB, FANCC, FANCD2, FANCE, FANCF, FANCG, FANCI, FANCL, FANCM, FAR1, FARS2, FBLN5, FBN1, FBXL4, FBXO31, FGF3, FGF8, FGFR1, FGFR3, FGFRL1, FH, FIG4, FKRP, FKTN, FLII, FLNA, FMN2, FOXG1, FOXH1, FRAS1, FREM1, FREM2, FRMD4A, FSHR, FTO, FTSJ1, G6PC3, GABRA1, GABRB2, GABRD, GABRG2, GAD1, GALC, GAS1, GATA1, GATA4, GATA6, GBA, GDI1, GEMIN4, GFM1, GJA1, GJA5, GJA8, GJB3, GJB4, GLG1, GLI2, GLYCTK, GMPPA, GMPPB, GNAO1, GNPAT, GOLGA2, GORAB, GP1BB, GPT2, GRIK2, GRIN1, GRIN2B, GRIP1, GTF2H5, GTF2I, GTF2IRD1, HARS2, HBA1, HBA2, HCCS, HCFC1, HCN1, HDAC4, HDAC8, HELZ, HES7, HHAT, HIC1, HIRA, HMGA2, HMGB1, HMGB3, HNRNPK, HSD17B4, HSPD1, HSPG2, HUWE1, IBA57, IER3IP1, IFIH1, IFT140, IFT172, IGF1, IGF1R, IGFBP4, IKBKG, IL1RAPL1, INA, INO80, INSR, IQCB1, IQSEC2, ISPD, ITGA3, ITGB6, JAM3, JMJD1C, KANK1, KANSL1, KARS, KAT6A, KAT6B, KATNB1, KCNAB2, KCNB1, KCNJ11, KCNJ2, KCNJ5, KCNJ6, KCNQ2, KCNT1, KCTD13, KCTD7, KDM5C, KDM6A, KIAA1033, KIAA2022, KIF11, KIF14, KIF1A, KIF1BP, KIF23, KIF2A, KIF5C, KIRREL3, KIT, KITLG, KMT2A, KMT2D, KRAS, L1CAM, LARGE, LARP7, LARS, LARS2, LAS1L, LEMD3, LETM1, LFNG, LIAS, LIG4, LIMK1, LINS1, LMNA, LRP5, LTC4S, MAD2L2, MAFB, MAGI2, MAGT1, MAN1B1, MANF, MAOA, MAPK1, MAPRE2, MASP1, MATN4, MBD5, MBTPS2, MCM4, MCOLN1, MCPH1, MCTP2, MECP2, MED12, MED13L, MED17, MED23, MED25, MEF2C, MEIS2, MESP2, METTL23, MFSD2A, MGAT2, MGME1, MID2, MITF, MKS1, MMACHC, MOCS1, MOCS2, MPC1, MPDU1, MPL, MPLKIP, MRE11A, MRPS22, MSMO1, MTFMT, MTHFR, MTSS1L, MVK, MXRA8, MYCN, MYH10, MYH3, MYO18B, NAA10, NADK2, NALCN, NANS, NARS2, NAT8L, NBN, NCAPG2, NDE1, NDP, NDST1, NDUFB11, NECAP1, NEK9, NELFA, NF1, NGLY1, NHEJ1, NHP2, NIN, NIPBL, NLGN1, NODAL, NOP10, NOTCH1, NPHP1, NPHP3, NPHP4, NR2E1, NR5A1, NRG1, NRXN1, NSD1, NSDHL, NSUN2, NTNG1, NUP107, OCLN, OFD1, OGDHL, ORC1, ORC4, ORC6, PAFAH1B1, PAH, PAK3, PALB2, PARN, PAX3, PAX6, PCDH12, PCDH15, PCDH19, PCDHB4, PCLO, PCNA, PCNT, PDGFB, PDGFRB, PDHA1, PDHX, PEX1, PEX10, PEX11B, PEX12, PEX13, PEX14, PEX16, PEX19, PEX2, PEX26, PEX3, PEX5, PEX6, PEX7, PGAP2, PGAP3, PHC1, PHF6, PHGDH, PIAS4, PIEZO2, PIGA, PIGL, PIGN, PIGO, PIGQ, PIGV, PIGW, PIGY, PIK3CB, PLCB1, PLEKHG2, PLK4, PLP1, PMM2, PNKP, PNPO, PNPT1, POC1A, POGZ, POLG, POLR1A, POLR1C, POMGNT1, POMGNT2, POMK, POMT1, POMT2, POR, PORCN, PPP1R15B, PPP2R1A, PPT1, PQBP1, PRDM16, PRKD1, PRKDC, PRSS12, PRUNE, PSAT1, PSMC3IP, PSPH, PTCH1, PTCHD1, PTDSS1, PTF1A, PTPN11, PTPRT, PTRH2, PTS, PUF60, PUS1, PYCR1, PYCR2, QARS, QDPR, RAB18, RAB33B, RAB39B, RAB3GAP1, RAB3GAP2, RAD21, RAD50, RAD51, RAD51C, RAI1, RAP1A, RAP1B, RAPSN, RARS, RARS2, RB1, RBBP8, RBM28, RBPJ, RECQL4, RELN, REN, RERE, RFC2, RFT1, RIPK4, RIPPLY2, RNASEH2A, RNASEH2B, RNASEH2C, RNASET2, RNF113A, RNF168, RPGRIP1, RPGRIP1L, RPL10, RPL11, RPL15, RPL26, RPL35A, RPL5, RPS10, RPS19, RPS24, RPS26, RPS28, RPS29, RPS6KA3, RPS7, RREB1, RRM2B, RSPRY1, RTEL1, RTTN, SALL1, SAMD9L, SAMHD1, SASS6, SATB2, SBF1, SC5D, SCN1A, SCN1B, SCN2A, SCN8A, SCN9A, SCO1, SCO2, SDCCAG8, SEC24C, SEMA3E, SEMA5A, SEPSECS, SETBP1, SF3B4, SGCA, SGCE, SHANK2, SHANK3, SHH, SIK1, SIL1, SIM1, SIN3A, SIX3, SIX6, SKI, SLC12A5, SLC12A6, SLC13A5, SLC16A2, SLC18A2, SLC19A3, SLC1A4, SLC20A2, SLC25A1, SLC25A19, SLC25A22, SLC2A1, SLC35A2, SLC35A3, SLC35C1, SLC35F5, SLC6A17, SLC6A8, SLC9A6, SLX4, SMAD4, SMARCA1, SMARCA2, SMARCA4, SMARCB1, SMARCE1, SMC1A, SMC3, SNAI2, SNAP29, SNRPB, SOX10, SOX11, SOX2, SOX3, SP110, SPATA5, SPDL1, SPG20, SPOCK1, SPR, SPTAN1, SSR4, ST3GAL3, ST3GAL5, STAMBP, STIL, STT3A, STT3B, STXBP1, SUCLA2, SUMF1, SV2A, SYNE1, SYNGAP1, SYP, TAF2, TAT, TBC1D20, TBC1D24, TBCD, TBCE, TBL1XR1, TBL2, TBX1, TBX2, TBX4, TBX6, TCF12, TCF4, TCTN2, TCTN3, TDGF1, TECPR2, TECR, TERT, TFAP2A, TGFBR2, TGIF1, THOC2, THOC6, THPO, TINF2, TMCO1, TMEM165, TMEM216, TMEM231, TMEM5, TMEM67, TMEM70, TNN, TP63, TRAF3IP1, TRAIP, TRAPPC11, TRAPPC9, TREX1, TRMT10A, TRNT1, TRPS1, TSEN15, TSEN2, TSEN34, TSEN54, TSPAN7, TSR2, TTC1, TTI1, TTI2, TUBA1A, TUBA3E, TUBA8, TUBB, TUBB2B, TUBB3, TUBB4A, TUBG1, TUBGCP4, TUBGCP6, TUFM, TUSC3, TWIST1, UBE2T, UBE3A, UBE3B, UBR1, UFD1L, UNC13A, UPB1, UPF3B, USB1, USP9X, VARS, VARS2, VIPAS39, VPS13B, VPS33B, VPS53, VRK1, WDPCP, WDR19, WDR45, WDR62, WDR73, WHSC1, WRAP53, WT1, WWOX, XIRP1, XPA, XPC, XPR1, XRCC2, XRCC4, XYLT1, YARS2, YWHAE, ZBTB16, ZBTB18, ZC3H14, ZDHHC9, ZEB2, ZIC1, ZIC2, ZNF335, ZNF41, ZNF519, ZNF592, ZNF674, ZNF711, ZNF81
  • Molecular confirmation of a clinical diagnosis
  • Establish the type of microcephaly and cause in order to provide information regarding prognosis, management and recurrence risk.
  • Testing of at-risk relatives for specific known variant(s) previously identified in an affected family member
  • Prenatal diagnosis for known familial pathogenic variant(s) in at-risk pregnancies
  • Next-Gen Sequencing

Ordering

J511
6 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81404x3, 81405x3, 81406x1, 81407x2, 81408x2
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Ashwal et al., (2009) Neurology 73(11): 887-897 (PMID: 19752457).
  2. Kaindl et al., (2010) Progress in Neurobiology 90:363-383 (PMID: 19931588).
  3. Verloes A, Drunat S, Gressens P, et al. Primary Autosomal Recessive Microcephalies and Seckel Syndrome Spectrum Disorders. 2009 Sep 1 [Updated 2013 Oct 31]. In: Pagon RA, Adam MP, Ardinger HH, et al., editors. GeneReviews [Internet]. Seattle (WA): Univers
  4. Woods CG (2004) Current Opinion in Neurobiology 14:112-117 (PMID: 15018946).
  5. Abuelo, D (2007) Semin Pediatr Neurol 14:118-127 (PMID: 17980308).
  6. Faheem et al., (2015) BMC Med Genomics 8 Suppl 1:S4 (PMID: 25951892).
  7. Shanmugham et al., Trio-based whole exome sequencing (WES): an effective diagnostic tool for patients with microcephaly [abstract]. In National Society of Genetic Counselors Annual Education Conference 2016 Sept 27-Oct 1, Seattle WA
Syndromic Macrocephaly/Overgrowth Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

AKT3, BRWD3, CCND2, CHD8, CUL4B, DNMT3A, EZH2, GLI3, GPC3, HEPACAM, HERC1, MED12, MTOR, NFIA, NFIX, NSD1, OFD1, PHF6, PIK3CA, PIK3R2, PPP2R5D, PTCH1, PTEN, RAB39B, RNF135, SETD2, SNX14, TBC1D7, UPF3B
  • Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Assist with treatment/ management decisions
  • Recurrence risk assessment
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

699
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81321x1, 81323x1, 81401x1, 81405x1, 81406x1
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Leukodystrophy Xpanded Panel

Forms and Documents

Fact Sheet Gene List Test Requisition Test Info Sheet Family Member Test Requisition

Test Details

AARS, AARS2, ABAT, ABCD1, ACADS, ACER3, ACOX1, ACY1, ADAR, ADGRG1, ADSL, AHDC1, AIMP1, ALDH3A2, ALDH6A1, AMN, AMPD2, ANK3, AP4B1, AP4S1, APOPT1, ARHGAP31, ARHGEF10, ARNT2, ARSA, ASNS, ASPA, ASXL1, AUH, BCAP31, BCS1L, BEST1, BMP4, BRAT1, CARS2, CCDC88A, CHMP2B, CLCN2, CLN6, CLP1, COL4A1, COL4A2, COX10, COX15, COX7B, CPLX1, CSF1R, CTBP1, CTC1, CTDP1, CYP27A1, CYP7B1, D2HGDH, DAG1, DARS, DARS2, DDHD2, DEAF1, DHFR, DHH, DLL4, DNM2, DOCK6, DPYS, DYRK1A, EARS2, EDNRB, EGR2, EIF2B1, EIF2B2, EIF2B3, EIF2B4, EIF2B5, ENTPD1, EOGT, ERCC2, ERCC6, ERCC8, FA2H, FAM126A, FBXL4, FGD4, FGFRL1, FIG4, FKRP, FOXC1, FOXG1, FOXRED1, GAA, GALC, GAN, GBE1, GCDH, GDAP1, GFAP, GFM1 (EFG1), GJA1, GJB1, GJC2, GLB1, GLUL, GLYCTK, GNAO1, GRM7, GRN, HEPACAM, HEXA, HSD17B4, HSPD1, HTRA1, IBA57, IDUA, IER3IP1, IFIH1, ISCA2, ITPA, KARS, KCNJ10, KCNT1, L2HGDH, LAMA1, LAMA2, LAMB1, LARGE1, LETM1, LIPT1, LITAF, LMNB1, LRPPRC, LYRM7, MAPT, MARS2, MAT1A, MCOLN1, MEF2C, MLC1, MOCS1, MOCS2, MPV17, MPZ, MRPS22, MTFMT, MTTP, MUT, NADK2, NDRG1, NDUFA1, NDUFA10, NDUFA11, NDUFA12, NDUFA2, NDUFA9, NDUFAF2, NDUFAF3 (C3ORF60), NDUFAF4 (C6ORF66), NDUFAF5, NDUFAF6, NDUFB3, NDUFB9, NDUFS1, NDUFS2, NDUFS3, NDUFS4, NDUFS6, NDUFS7, NDUFS8, NDUFV1, NDUFV2, NDUFV3, NEFL, NFU1, NGLY1, NOTCH1, NOTCH3, NRXN1, NSD2, NUBPL, OCRL, PAFAH1B1, PC, PCDH12, PDYN, PEX1, PEX10, PEX11B, PEX12, PEX13, PEX14, PEX16, PEX19, PEX2, PEX26, PEX3, PEX5, PEX6, PEX7, PGAP1, PHGDH, PHYH, PIGA, PLEKHG2, PLP1, PMP22, POLG, POLR1C, POLR3A, POLR3B, POMK, POMT1, PPP2R1A, PRKDC, PRPS1, PRX, PSAP, PSEN1, PTEN, PURA, PYCR2, QARS, RARS, RBPJ, RMND1, RNASEH2A, RNASEH2B, RNASEH2C, RNASET2, RNF216, RPIA, RPS6KC1, SAMHD1, SBF2, SCP2, SDHA, SDHAF1, SDHB, SDHD, SEPSECS, SH3TC2, SHANK3, SHPK, SLC16A2, SLC17A5 , SLC1A4, SLC25A1, SLC25A12, SLC25A22, SLC33A1, SLC35A2, SLC46A1, SLC6A8, SNIP1, SOX10, SPATA5, SPG11, SPG20, SPTAN1, SQSTM1, SSR4, STAMBP, STAT1, STXBP1, SUMF1, SURF1, SYNE1, TACO1, TAF2, TARS2, TM4SF20, TMEM126B, TMEM165, TMEM187, TMEM70, TRAPPC9, TREM2, TREX1, TRMT10A, TRMT5, TSC1, TSEN54, TUBB2A, TUBB4A, TUFM, TYMP, TYROBP, UBE2A, UPB1, VARS2, VCP, VPS11, WWOX, ZEB2, ZFYVE26, ZNF335
  • Molecular confirmation of a clinical diagnosis
  • To assist with decisions about treatment and management of individuals with leukodystrophy or leukoencephalopathy
  • Testing of at-risk relatives for specific known variant(s) previously identified in an affected family member
  • Prenatal diagnosis for known familial pathogenic variant(s) in at-risk pregnancies
  • Next-Gen Sequencing

Ordering

J853
6 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81404x5, 81405x6, 81406x5, 81401x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Vanderver A et al. Leukodystrophy Overview. 2014 Feb 6. In: Pagon RA, Adam MP, Ardinger HH, et al., editors. GeneReviews [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2016. Available from: https://www.ncbi.nlm.nih.gov/books/NBK184570/.
  2. Bonkowsky et al. (2010) Neurology 75 (8):718-25 (PMID: 20660364)
  3. Heim P, Claussen M, Hoffmann B, Conzelmann E, Gärtner J, Harzer K, Hunneman DH, Köhler W, Kurlemann G, Kohlschütter A. Leukodystrophy incidence in Germany. Am J Med Genet. 1997;71:475–8 (PMID: 9286459).
  4. Zou et al. Whole exome sequencing: an effective and comprehensive genetic testing approach for leukodystrophy [abstract submitted] To be presented at the 2017 ASHG Annual Genetics Meeting, October 17-21, Orlando, FL.
L1CAM Gene Sequencing & Del/Dup

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Patients with hydrocephalus and at least one L1CAM–associated finding
  • Carrier testing in female relatives
  • Risk assessment
  • Prenatal diagnosis in at-risk pregnancies
  • Capillary Sequencing
  • Deletion/Duplication Analysis

Ordering

552
3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81407x1, 81479x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Vos, J. (2010) J Med Genet. 47(3):169-75
  2. Jackson, SR. (2009) Pediatr Surg Int. 25(9):823-5
  3. Jouet, M. (1994) Nature Genet. 7: 402-407, 1994
  4. Finckh, U. (2000) Am. J. Med. Genet. 92: 40-46
Holoprosencephaly Panel & Del/Dup

Forms and Documents

Test Info Sheet Test Requisition

Test Details

SHH, SIX3, TGIF, ZIC2
  • Confirmation of clinical diagnosis
  • Identification of the specific gene defect(s) to allow: (a) Identification of non-expressing mutation carriers in families with an affected member (b) Prenatal diagnosis for the specific mutation in the family
  • MLPA
  • Next-Gen Sequencing

Ordering

2371
3-4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81479x1
Yes
Yes
  • 742.2 Reduction deformities of brain Absence of part of brain, Agenesis of part of brain, Agyria Aplasia of part of brain, Arhinencephaly, Holoprosencephaly, Hypoplasia of part of brain Microgyria
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Wallis et al., (2000) Human Mutat 16:99-108
  2. Dubourg et al., (2004) Hum Mutat 24: 43-51
  3. Bendavid et al., (2005) Hum Genet 119: 1-8
  4. Bendavid et al., (2006) J Med Genet 43: 496-500
  5. Dubourg et al., (2007) Orphan J Rare Dis 2:8
  6. El-Jaik et al., (2007) Mol Genet Metab 90:97-111
  7. Bendavid et al., (2009) Hum Mutat 30: 1175-1182
  8. Lacbawan et al., (2009) J Med Genet 46:389-98
  9. Roessler et al., (2009) Hum Mutat 10:921- 993
  10. Solomon et al., (2009) J Med Genet 47:513-24
  11. Muenke, M. and Gropman, A. Holoprosencephaly Overview, www.genereviews.org. (2010)
  12. Muenke et al., (2010) Am J Med Genet 154C: 52-61
  13. Paulussen et al., (2010) Eur J Hum Genet 18: 999-1005.
  14. Solomon et al., (2010) Am J Med Genet 154C: 133-141
Cerebral Cavernous Malformations (CCM) Panel

Forms and Documents

Test Info Sheet Test Requisition

Test Details

CCM2, KRIT1, PDCD10
  • Confirmation of a clinical diagnosis
  • Identification of family members at-risk for cerebral cavernous malformations (CCMs)
  • Recurrence risk assessment
  • Prenatal diagnosis in families with a known mutation
  • Capillary Sequencing
  • Deletion/Duplication Analysis

Ordering

526
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81479x1
No
Yes
  • 747.81 Anomalies of cerebrovascular system, Arteriovenous malformation of brain, Cerebral arteriovenous aneurysm, congenital Congenital anomalies of cerebral vessels
  • 228 Hemangioma and lymphangioma,
  • 747.6 Other anomalies of peripheral vascular system, Absence of artery or vein, NEC Anomaly of artery or vein, NEC Atresia of artery or vein, NEC Arteriovenous aneurysm (peripheral), Arteriovenous malformation of the peripheral vascular system Congenital: aneurysm (peripheral) phlebectasia stricture, artery varix Multiple renal arteries Excludes: anomalies of: cerebral vessels (747.81) pulmonary artery (747.3) congenital retinal aneurysm (743.58) hemangioma (228.00-228.09) lymphangioma (228.1)
  • 325 Phlebitis and thrombophlebitis of intracranial venous sinuses, Embolism of cavernous, lateral, or other intracranial or unspecified intracranial venous sinu,s Endophlebitis of cavernous, lateral, or other intracranial or unspecified intracranial venous sinus Phlebitis, septic or suppurative of cavernous, lateral, or other intracranial or unspecified intracranial venous sinus Thrombophlebitis of cavernous, lateral, or other intracranial or unspecified intracranial venous sinus Thrombosis of cavernous, lateral, or other intracranial or unspecified intracranial venous sinus Excludes: that specified as: complicating pregnancy, childbirth, or the puerperium (671.5) of nonpyogenic origin (437.6)
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Cavé-Riant et al. (2002) Eur J Hum Genet 10:733-740.
  2. Chen et al. (2002) J Neurol Sci 196:91-96.
  3. Davenport et al. (2001) Neurology 56:540-543.
  4. Denier et al. (2006) Ann Neurol 60:550-556.
  5. Eerola et al. (2000) Hum Mol Genet 9(9):1351-1355.
  6. Faurobert and Albiges-Rizo. (2010) FEBS J 277:1084-1096.
  7. Labauge et al. (2006) Arch Ophthalmol 124:885-886
  8. Liquori et al. (2007) Am J Hum Genet 80:69-75.
  9. Riant et al. (2010) FEBS J 277:1070-1075.
  10. Stahl et al. (2008) Hum Mutat 29(5):709- 717.
Dementia Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

APP, DCTN1, GRN, MAPT, PRNP, PSEN1, PSEN2, SQSTM1, TARDBP, TREM2, TYROBP
  • Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Assist with treatment/ management decisions
  • Recurrence risk assessment

SAMPLES NOT ACCEPTED FROM INDIVIDUALS UNDER 18 YEARS OF AGE.

  • Next-Gen Sequencing

Ordering

T844
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81404x1; 81405x2; 81406x2
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Comprehensive Holoprosencephaly Panel

Forms and Documents

Test Info Sheet Test Requisition

Test Details

CDON, DISP1, DLL1, FGF8, FGFR1, FOXH1, GAS1, GLI2, NODAL, PTCH1, SHH, SIX3, SMAD2, STIL, TDGF1, TGIF1, ZIC2
  • Identification of the specific molecular basis of holoprosencephaly and microform variants
  • Genetic counseling, carrier testing, and recurrence risk assessment
  • Preparation for prenatal testing in future pregnancies
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

TB51
3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs | Extracted DNA

Billing

81479x1; 81405x1
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

Movement Disorders

Comprehensive Hereditary Spastic Paraplegia Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

ABCD1, ALDH18A1, ALS2, AP4B1, AP4E1, AP4M1, AP4S1, AP5Z1, ATL1, ATP13A2, B4GALNT1, BSCL2, C12ORF65, CYP2U1, CYP7B1, DDHD1, DDHD2, ERLIN2, FA2H, GBA2, GJC2, KIAA0196, KIF1A, KIF1C, KIF5A, L1CAM, NIPA1, NT5C2, PLP1, PNPLA6, REEP1, SACS, SLC16A2, SPAST, SPG11, SPG20, SPG21, SPG7, TECPR2, TFG, VPS37A, ZFYVE26
  • Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Assist with treatment/management decisions
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

941
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81448x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Uncomplicated Hereditary Spastic Paraplegia Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

ALS2, AP5Z1, ATL1, BSCL2, CYP7B1, DDHD1, KIAA0196, KIF1A, KIF5A, NIPA1, PNPLA6, REEP1, SPAST, SPG7
  • Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Assist with treatment/management decisions
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

942
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81448x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Hereditary Spastic Paraplegia Related Inborn Errors of Metabolism Panel
Cerebral Palsy Xpanded Panel

Forms and Documents

Test Requisition Test Info Sheet Gene List

Test Details

AARS, AARS2, AASS, ABCC8, ABCD1, ABHD12, ACAD9, ACAT2, ACO2, ACOX1, ACP2, ACP5, ACSL4, ACTA1, ACTB, ACTG1, ACY1, ADA2, ADAM22, ADAR, ADCY5, ADD3, ADGRB2, ADGRG1, ADK, ADRA2B, ADSL, AFG3L2, AGA, AHDC1, AHI1, AIFM1, AIMP1, AIMP2, AIP, AIPL1, AKT1, AKT3, ALDH18A1, ALDH3A2, ALDH6A1, ALG11, ALG13, ALG3, ALG6, ALS2, AMACR, AMMECR1, AMPD2, AMT, ANG, ANK3, ANKLE2, ANKRD11, ANO10, ANO3, AP1S2, AP3B2, AP3D1, AP4B1, AP4E1, AP4M1, AP4S1, AP5Z1, APOPT1, APTX, ARCN1, ARFGEF2, ARG1, ARHGAP31, ARHGEF15, ARHGEF9, ARID1B, ARL13B, ARL6IP1, ARMC9, ARNT2, ARSA, ARSI, ARV1, ARX, ASCC1, ASNS, ASPA, ASPM, ASTN2, ASXL1, ATAD3A, ATAD3B, ATCAY, ATF4, ATIC, ATL1, ATM, ATN1, ATP13A2, ATP1A2, ATP1A3, ATP2B3, ATP2B4, ATP5F1A, ATP6AP2, ATP6V0A2, ATP6V1A, ATP6V1E1, ATP7A, ATP7B, ATP8A2, ATR, ATRX, ATXN1, ATXN10, ATXN2, ATXN3, ATXN7, ATXN8, AUH, AUTS2, B3GALNT2, B4GALNT1, B4GAT1, B9D1, BAZ1B, BCAP31, BCL11B, BCOR, BCS1L, BEAN1, BICD2, BMPER, BOLA3, BRAF, BRAT1, BSCL2, BUB1B, C12ORF65, C19orf12, C19ORF70, C21ORF2, C2CD3, C9ORF72, CA8, CACNA1A, CACNA1B, CACNA1D, CACNA1G, CACNA2D1, CACNA2D2, CAD, CAMTA2, CAPN1, CARS2, CASK, CASR, CAV1, CC2D1A, CC2D2A, CCBE1, CCDC22, CCDC88A, CCDC88C, CCND2, CCNF, CCT5, CDC42, CDK13, CDK5, CDK5RAP2, CDK6, CDKL5, CENPE, CENPJ, CEP104, CEP120, CEP135, CEP152, CEP290, CEP41, CEP63, CHAMP1, CHAT, CHCHD10, CHD2, CHD4, CHEK2, CHMP1A, CHMP2B, CHN1, CHRNA7, CIT, CIZ1, CKAP2L, CLCN2, CLCN4, CLIC2, CLIP2, CLN6, CLP1, CLPB, CLTC, CNKSR2, CNTNAP2, COA7, COASY, COG2, COG8, COL12A1, COL18A1, COL25A1, COL4A1, COL4A2, COL6A1, COL6A2, COL6A3, COLEC11, COQ2, COQ4, COQ7, COQ9, COX10, COX15, CP, CPLX1, CPS1, CPT1A, CPT1C, CPT2, CRADD, CRB1, CRLF1, CRX, CSF1R, CSNK2A1, CSPP1, CSTB, CTBP1, CTC1, CTDP1, CTNNB1, CTNND2, CTSD, CUL4B, CYB5R3, CYP27A1, CYP2U1, CYP7B1, D2HGDH, DAG1, DAO, DARS, DARS2, DCAF17, DCHS1, DCTN1, DCX, DDB2, DDC, DDHD1, DDHD2, DDX3X, DEAF1, DENND5A, DGUOK, DHCR24, DHCR7, DHDDS, DHFR, DKK1, DLAT, DLD, DLL4, DMPK, DMXL2, DNAJC12, DNAJC3, DNAJC6, DNASE1L3, DNM1, DNM1L, DNM2, DNMT1, DNMT3A, DOCK6, DOCK7, DPM3, DPYS, DRD2, DSTYK, DYNC1H1, DYRK1A, EARS2, ECHS1, ECM1, EDNRB, EED, EEF1A2, EEF2, EHMT1, EIF2AK3, EIF2B1, EIF2B2, EIF2B3, EIF2B4, EIF2B5, EIF2S3, ELAC2, ELN, ELOVL4, ELOVL5, ELP2, ELP4, EMC1, EML1, ENTPD1, EOGT, EPB41L4A, EPCAM, EPG5, EPHA4, ERBB4, ERCC1, ERCC2, ERCC3, ERCC4, ERCC5, ERCC6, ERLIN1, ERLIN2, ERMARD, ETFA, ETFB, ETFDH, ETHE1, EXOSC3, EXOSC8, EZH2, FA2H, FAAH, FADD, FAN1, FAR1, FARS2, FASN, FBXL4, FBXO7, FGF12, FGF14, FGFR1, FGFR2, FGFR3, FGFRL1, FH, FIG4, FITM2, FKRP, FKTN, FLI1, FLNA, FLRT1, FMR1, FOXC1, FOXE1, FOXG1, FOXRED1, FRAS1, FREM2, FRRS1L, FTL, FTO, FUCA1 , FUS, FXN, GABBR2, GABRA1, GABRB1, GABRB2, GABRB3, GAD1, GALC, GAN, GATAD2B, GBA, GBA2, GBE1, GCDH, GCH1, GCK, GCSH, GDF6, GEMIN4, GFAP, GFM1, GFM2, GJA1, GJB1, GJC2, GLB1, GLDC, GLE1, GLI2, GLI3, GLRA1, GLRB, GLRX5, GLUL, GLYCTK, GM2A, GMPPB, GNA11, GNAL, GNAO1, GNAS, GNB1, GPHN, GPR101, GPR35, GPR88, GPSM2, GPT2, GPX4, GRIA3, GRID2, GRIK2, GRIN1, GRIN2A, GRIN2B, GRIN2D, GRIP1, GSS, GTF2I, GTF2IRD1, GTPBP3, GUCY2D, GUF1, HACE1, HADH, HCFC1, HCN1, HDAC8, HECW2, HEPACAM, HERC1, HIBCH, HIC1, HIVEP2, HNMT, HNRNPA1, HNRNPU, HPCA, HPGD, HPRT1, HSD17B10, HSD17B4, HSPD1, HSPG2, HTRA1, HTRA2, HTT, HUWE1, HYLS1, IARS, IBA57, IDH1, IDH2, IDH3A, IDS, IDUA, IER3IP1, IFIH1, IFT140, IKBKG, IL6, IMPDH1, INPP4A, INPP5E, INPP5K, INS, IQCB1, IQSEC2, ISCA2, ISPD, ITM2B, ITPA, ITPR1, JAM3, JPH3, KANK1, KARS, KAT6B, KATNB1, KCNA1, KCNA2, KCNAB1, KCNB1, KCNC3, KCND3, KCNE5, KCNH1, KCNJ11, KCNJ13, KCNJ6, KCNMA1, KCNQ2, KCNQ3, KCNQ5, KCNT1, KCTD17, KDM5C, KDM6A, KIAA0556, KIAA0586, KIDINS220, KIF11, KIF1A, KIF1BP, KIF1C, KIF2A, KIF5A, KIF5C, KIF7, KLC2, KLC4, KLF13, KLHL15, KMT2A, KMT2B, KNL1, KRAS, KY, KYNU, L1CAM, L2HGDH, LAGE3, LAMA1, LAMA2, LAMB1, LARGE1, LARP7, LCA5, LETM1, LGI1, LIAS, LIMK1, LIPT1, LIPT2, LMAN2L, LMNB1, LMNB2, LRAT, LRFN2, LYRM7, MAFB, MAG, MAN2B1, MAPK10, MAPT, MARS, MARS2, MAT1A, MATR3, MBD5, MBOAT7, MBTPS2, MCCC1, MCCC2, MCOLN1, MCPH1, MDH2, MDM2, MECP2, MECR, MED12, MED13L, MED17, MED25, MEF2C, MFF, MFN2, MFSD2A, MGAT2, MICU1, MICU2, MKS1, MLC1, MLH1, MLH3, MLYCD, MMADHC, MME, MOCS1, MOCS2, MPC1, MPDZ, MPV17, MPZ, MR1, MRE11, MRPS22, MSH2, MSH6, MST1, MTFMT, MTO1, MTOR, MTPAP, MUT, MYO5A, NAA10, NACC1, NADK2, NAGA, NAGPA, NALCN, NANS, NARS2, NAXE, NBN, NDE1, NDUFA1, NDUFA10, NDUFA11, NDUFA12, NDUFA13, NDUFA2, NDUFA9, NDUFAF1, NDUFAF2, NDUFAF3, NDUFAF4, NDUFAF5, NDUFAF6, NDUFB3, NDUFB9, NDUFS1, NDUFS2, NDUFS3, NDUFS4, NDUFS6, NDUFS7, NDUFS8, NDUFV1, NDUFV2, NECAP1, NEDD4L, NEFH, NEK1, NELFA, NEXMIF, NFIX, NFU1, NIN, NIPA1, NIPBL, NKAIN2, NKX2-1, NKX2-5, NKX6-2, NMNAT1, NOP56, NOTCH1, NOTCH3, NPC1, NPC2, NPHP1, NR4A2, NRXN1, NSD1, NSD2, NSDHL, NSUN2, NT5C2, NTNG1, NTRK2, NUBPL, NUP107, NUP62, NUS1, OCLN, OCRL, OFD1, OPA1, OPA3, OPHN1, OPTN, OSGEP, OTUD6B, PAFAH1B1, PAH, PAK3, PANK2, PARK7, PARS2, PAX3, PAX6, PAX8, PC, PCCA, PCCB, PCDH12, PCDH19, PCLO, PCYT1A, PDC, PDE10A, PDGFB, PDGFRB, PDHA1, PDHB, PDHX, PDP1, PDX1, PDYN, PEX1, PEX10, PEX11B, PEX12, PEX13, PEX14, PEX16, PEX19, PEX2, PEX26, PEX3, PEX5, PEX6, PEX7, PFN1, PGAP1, PGAP2, PHC1, PHF6, PHGDH, PHKA1, PHYH, PIGA, PIGG, PIGN, PIGP, PIGV, PIK3CA, PIK3R2, PINK1, PLA2G6, PLAA, PLCB1, PLEKHG2, PLK4, PLP1, PMP22, PMPCA, PMS1, PMS2, PNKD, PNKP, PNP, PNPLA6, PNPLA8, PNPO, PNPT1, POLA1, POLG, POLR1C, POLR1D, POLR3A, POLR3B, POMGNT1, POMGNT2, POMK, POMT1, POMT2, PON1, PON2, PON3, PPARGC1A, PPP1R15B, PPP2R1A, PPP2R2B, PPP3CA, PPT1, PQBP1, PRDM8, PRICKLE1, PRKCG, PRKDC, PRKN, PRKRA, PRNP, PRPH, PRRT2, PSAP, PSAT1, PSEN1, PTEN, PTPN23, PTS, PURA, PUS3, PYCR2, QARS, QDPR, QKI, RAB11A, RAB12, RAB18, RAB27A, RAB3GAP1, RAB3GAP2, RAD21, RAD50, RAG1, RANBP2, RARS2, RAX, RBPJ, RD3, RDH12, RECQL4, REEP1, REEP2, RELN, RETREG1, RFC2, RFT1, RMND1, RNASEH2A, RNASEH2B, RNASEH2C, RNASET2, RNF113A, RNF125, RNF216, ROGDI, RPE65, RPGRIP1, RPGRIP1L, RPIA, RPS6KA3, RRM2B, RSPH4A, RTN2, RTN4IP1, RTTN, SACS, SAMHD1, SARS2, SASS6, SATB2, SCARB2, SCN10A, SCN1A, SCN1B, SCN2A, SCN4A, SCN8A, SCO1, SCP2, SCYL1, SDHA, SDHAF1, SDHB, SDHD, SEMA5A, SEPSECS, SERAC1, SERPINI1, SETBP1, SETD5, SETX, SF3B4, SGCE, SH2D1A, SHANK3, SHROOM4, SIGMAR1, SIK1, SIL1, SIX6, SLC12A5, SLC13A5, SLC16A2, SLC17A5 , SLC18A2, SLC19A3, SLC1A2, SLC1A4, SLC20A2, SLC22A5, SLC25A1, SLC25A12, SLC25A15, SLC25A19, SLC25A20, SLC25A22, SLC26A1, SLC26A4, SLC2A1, SLC2A3, SLC30A10, SLC33A1, SLC35A2, SLC35A3, SLC35C1, SLC39A14, SLC39A8, SLC46A1, SLC6A1, SLC6A17, SLC6A3, SLC6A5, SLC6A8, SLC6A9, SLC7A2, SLC9A1, SLC9A6, SLCO2A1, SMARCA2, SMARCB1, SMC1A, SMC3, SMO, SMOC1, SMPD1, SNAP25, SNAP29, SNCA, SNCAIP, SNX14, SOBP, SOD1, SOX10, SOX2, SOX6, SPART, SPAST, SPATA5, SPATA7, SPG11, SPG21, SPG7, SPR, SPTAN1, SPTBN2, SQSTM1, SRD5A3, SRGAP2, SRPX2, SSR4, ST3GAL5, STAMBP, STAT1, STAT2, STAT3, STIL, STN1, STRA6, STS, STUB1, STX16, STX1B, STXBP1, SUCLA2, SUCLG1, SUMF1, SUOX, SURF1, SUZ12, SYNE1, SYNGAP1, SYNJ1, SYT14, SYT2, SZT2, TAF1, TAF13, TAF15, TAF2, TANGO2, TARDBP, TARS2, TBC1D20, TBC1D24, TBCD, TBCE, TBCK, TBK1, TBL1XR1, TBL2, TBP, TCF4, TCOF1, TCTN1, TCTN2, TECPR2, TELO2, TENM1, TFG, TGFBR2, TGM6, TH, THAP1, TIMM50, TIMM8A, TIMMDC1, TK2, TMEM126B, TMEM138, TMEM216, TMEM231, TMEM237, TMEM240, TMEM67, TMEM70, TMTC3, TNR, TOE1, TOPORS, TOR1A, TOR1AIP1, TP53, TP53RK, TPI1, TPK1, TPRKB, TRAIP, TRAK1, TRAPPC11, TRAPPC12, TRAPPC9, TREM2, TREX1, TRIM8, TRIT1, TRMT5, TRPV4, TSC1, TSC2, TSEN15, TSEN2, TSEN34, TSEN54, TSFM, TSHB, TSHR, TTBK2, TTC19, TTF1, TTPA, TTR, TUBA1A, TUBA8, TUBB, TUBB2A, TUBB2B, TUBB3, TUBB4A, TUBG1, TUBGCP4, TUBGCP6, TUFM, TULP1, TWIST1, TWNK, TXN2, TYMP, TYROBP, UBA5, UBB, UBE3A, UBQLN2, UCHL1, UNC13A, UNC80, UPB1, UQCRQ, UROC1, USP18, USP8, USP9X, VAC14, VAMP1, VAPB, VARS2, VCP, VIPAS39, VLDLR, VPS11, VPS13A, VPS13C, VPS16, VPS33B, VPS37A, VPS53, VWA3B, WARS2, WASHC4, WASHC5, WDR45, WDR48, WDR62, WDR73, WDR81, WT1, WWOX, XIAP, XPA, XPC, XPR1, XRCC4, YME1L1, YWHAE, YWHAG, ZBTB18, ZEB2, ZFR, ZFYVE26, ZFYVE27, ZIC1, ZNF335, ZNF423, ZNF592, ZNHIT3
  • Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Assist with treatment/ management decisions
  • Recurrence risk assessment
  • Prenatal diagnosis for known familial pathogenic variant(s) in at-risk pregnancies
  • Next-Gen Sequencing

Ordering

T851
6 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81185x1, 81302x1, 81404x1, 81405x2, 81406x2, 81408x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Ataxia Xpanded Panel

Forms and Documents

Test Requisition Test Info Sheet Gene List Family Member Test Requisition

Test Details

AAAS, AARS, AARS2, AASS, ABCA1, ABCB7, ABCC6, ABCC8, ABCD1, ABHD12, ABHD5, ACAT2, ACBD6, ACD, ACO2, ACOX1, ACP5, ACTB, ADAR, ADCK3, ADCY5, ADCY6, ADD3, ADGRG1, ADSL, AFF2, AFG3L2, AGA, AGRN, AHDC1, AHI1, AIFM1, AIMP1, AIP, AIPL1, ALAD, ALDH18A1, ALDH3A2, ALDH5A1, ALDH7A1, ALG6, ALK, ALS2, AMACR, AMPD2, ANG, ANK3, ANKLE2, ANKRD11, ANO10, ANO3, ANOS1, AP1S2, AP4B1, AP4E1, AP4M1, AP4S1, AP5Z1, APC, APOA1, APOB, APOPT1, APP, APTX, ARFGEF2, ARG1, ARHGAP31, ARID1B, ARL13B, ARL6, ARL6IP1, ARNT2, ARSA, ARSI, ARX, ASL, ASNS, ASPM, ASS1, ATCAY, ATG5, ATL1, ATM, ATP13A2, ATP1A2, ATP1A3, ATP2B3, ATP2B4, ATP5A1, ATP5E, ATP6AP2, ATP7A, ATP7B, ATP8A2, ATPAF1, ATPAF2, ATRX, AUH, B3GALNT2, B3GALT6, B4GALNT1, B4GAT1, B9D1, BBIP1, BBS1, BBS10, BBS12, BBS2, BBS4, BBS5, BBS7, BBS9, BCAP31, BCKDHA, BCKDHB, BCOR, BCS1L, BICD2, BRAT1, BSCL2, BTD, BTK, C10orf2, C12ORF65, C19orf12, C5orf42, CA8, CACNA1A, CACNA1B, CACNA1D, CACNA1G, CACNB4, CACNG2, CAMTA1, CAPN1, CARS2, CASK, CAV1, CBS, CC2D1A, CC2D2A, CCDC88C, CCT5, CDH15, CDK5RAP2, CDK6, CDKL5, CECR1, CENPJ, CEP135, CEP152, CEP290, CEP41, CEP63, CHAMP1, CHAT, CHCHD10, CHD2, CHD7, CHL1, CHMP1A, CHMP2B, CISD2, CIZ1, CKAP2L, CLCN2, CLIC2, CLIP1, CLK2, CLMP, CLN3, CLN5, CLN6, CLN8, CLP1, CLPB, CLPP, CLRN1, CNTN4, CNTNAP1, COA3, COASY, COG4, COG5, COL18A1, COL4A1, COL4A2, COL6A3, COQ2, COX10, COX14, COX15, COX20, COX6B1, CP, CPS1, CPT1A, CPT1C, CRADD, CRB1, CRBN, CREBBP, CRX, CSF1R, CSPP1, CSTB, CTBP1, CTC1, CTDP1, CTLA4, CTNNB1, CTNND2, CTSD, CTSF, CUL4B, CWF19L1, CYC1, CYP27A1, CYP2U1, CYP7B1, DAG1, DAO, DARS, DARS2, DBT, DCAF17, DCTN1, DCX, DDC, DDHD1, DDHD2, DDX3X, DEAF1, DHCR24, DHFR, DKC1, DLAT, DLD, DLGAP4, DLL4, DMXL2, DNAJC13, DNAJC19, DNAJC3, DNAJC5, DNAJC6, DNASE1L3, DNM1, DNM1L, DNM2, DNMT1, DOCK6, DOCK8, DPM1, DPYD, DPYS, DRD2, DUSP6, DYNC1H1, DYRK1A, DYSF, EARS2, EBF3, ECHS1, EDC3, EDN3, EDNRB, EEF2, EGR2, EHMT1, EIF2B1, EIF2B2, EIF2B3, EIF2B4, EIF2B5, EIF4G1, ELOVL4, ELOVL5, EML1, EMX2, ENPP1, ENTPD1, EOGT, EPB41L1, EPB41L4A, ERBB4, ERCC1, ERCC2, ERCC3, ERCC4, ERCC5, ERCC6, ERCC8, ERLIN1, ERLIN2, ETHE1, EXOSC3, EXOSC8, EXT2, EZH2, FA2H, FAAH, FAM134B, FAR1, FARS2, FASTKD2, FBXL4, FBXO31, FBXO7, FEZF1, FGD4, FGF14, FGF17, FGF8, FGFR1, FIG4, FKRP, FKTN, FLNA, FLRT1, FLRT3, FLVCR1, FMN2, FOXG1, FOXP1, FOXP3, FOXRED1, FTL, FUCA1 , FUS, FUZ, FXN, GABRA1, GABRB2, GABRD, GABRG2, GAD1, GALC, GAMT, GAN, GATAD2B, GBA, GBA2, GBE1, GCDH, GCH1, GDF3, GDF6, GEMIN4, GEMIN5, GFAP, GFM1, GIGYF2, GJA1, GJB1, GJB2, GJB6, GJC2, GLB1, GLI2, GLRA1, GLRX5, GLYCTK, GMPPA, GMPPB, GNAL, GNAO1, GNAQ, GNRH1, GNRHR, GOSR2, GPI, GPR101, GPR88, GRID2, GRIK2, GRIN1, GRIN2B, GRM1, GRN, GSS, GUCY2D, HACE1, HARS, HARS2, HCFC1, HCN1, HDAC8, HEPACAM, HESX1, HEXA, HEXB, HFE, HGSNAT, HIBCH, HIC1, HK1, HLA-DPB1, HMBS, HMGCS2, HNRNPA1, HNRNPA2B1, HPCA, HPGD, HPRT1, HS6ST1, HSD17B10, HSD17B4, HSPD1, HSPG2, HTRA2, IBA57, IDH2, IDUA, IFIH1, IFRD1, IFT140, IFT172, IFT27, IL10, IL12A, IL17RD, IL23R, IL6, IMPDH1, INPP5E, IQCB1, IQSEC2, ISCA2, ISPD, ITM2B, ITPR1, JAM3, KANK1, KAT6A, KATNB1, KCNA1, KCNA2, KCNAB2, KCNB1, KCNB2, KCNC3, KCND3, KCNJ10, KCNJ13, KCNJ6, KCNMA1, KCNQ2, KCNQ3, KCNT1, KCTD17, KCTD7, KDM5C, KDM6A, KIAA0196, KIAA0226, KIAA0586, KIAA2022, KIF1A, KIF1C, KIF2A, KIF5A, KIF5C, KIRREL3, KISS1, KISS1R, KLC2, KLC4, L1CAM, L2HGDH, LAMA1, LAMB2, LARS, LARS2, LCA5, LDLR, LHX4, LIAS, LIPT1, LMBRD1, LMNB1, LMNB2, LRAT, LRPPRC, LRRK2, LRSAM1, LYRM7, LZTFL1, MAG, MAN1B1, MAN2B1, MAPT, MARS, MARS2, MAT1A, MATR3, MBD5, MCOLN1, MCPH1, MECP2, MED13L, MED17, MED23, MED25, MEF2C, MEFV, MEOX1, METTL23, MFN2, MFSD2A, MFSD8, MICU1, MKKS, MKS1, MLC1, MLLT3, MMADHC, MOCS1, MOCS2, MPDU1, MPV17, MPZ, MR1, MRE11A, MRPS22, MTFMT, MTO1, MTPAP, MTTP, MUT, MVK, MYCN, MYO5A, MYT1L, NAA10, NADK2, NAGA, NAGLU, NAGPA, NALCN, NAT8L, NDE1, NDRG1, NDST1, NDUFA1, NDUFA10, NDUFA11, NDUFA12, NDUFA13, NDUFA2, NDUFA4, NDUFA9, NDUFAF1, NDUFAF2, NDUFAF3, NDUFAF4, NDUFAF5, NDUFAF6, NDUFB3, NDUFB9, NDUFS1, NDUFS2, NDUFS3, NDUFS4, NDUFS6, NDUFS7, NDUFS8, NDUFV1, NDUFV2, NECAP1, NEFH, NEFL, NFU1, NGLY1, NHP2, NIPA1, NKAIN2, NKX2-1, NKX6-2, NME1, NMNAT1, NOD2, NOP10, NOTCH1, NOTCH3, NPC1, NPC2, NPHP1, NRAS, NSD1, NSMF, NSUN2, NT5C2, NTNG1, NUBPL, NUP62, OCLN, OPA1, OPA3, OPHN1, OPTN, OTC, OTUD4, OTX2, PACRG, PAFAH1B1, PAFAH1B3, PAH, PAK3, PANK2, PARK2, PARK7, PARN, PAX3, PAX6, PCCA, PCCB, PCDH19, PCLO, PCNA, PDC, PDE10A, PDE8B, PDGFB, PDGFRB, PDHA1, PDHX, PDP1, PDSS2, PDYN, PET100, PEX1, PEX10, PEX11B, PEX12, PEX13, PEX14, PEX16, PEX19, PEX2, PEX26, PEX3, PEX5, PEX6, PEX7, PFN1, PGAP1, PGK1, PGM3, PHC1, PHGDH, PHOX2B, PHYH, PIGA, PIGN, PIGQ, PIK3R5, PINK1, PLA2G6, PLCB1, PLEKHG2, PLEKHG4, PLP1, PLXND1, PMM2, PMP22, PMPCA, PNKD, PNKP, PNP, PNPLA6, PNPLA8, PNPT1, POLA1, POLG, POLG2, POLR1C, POLR3A, POLR3B, POMGNT1, POMGNT2, POMK, POMT1, POMT2, PON1, PON2, PON3, POU1F1, PPARGC1A, PPM1K, PPT1, PQBP1, PRF1, PRICKLE1, PRKCG, PRKRA, PRNP, PROK2, PROKR2, PROP1, PRPH, PRPS1, PRRT2, PRSS12, PRTN3, PRX, PSAP, PSEN1, PSEN2, PTCH1, PTCH2, PTCHD1, PTPN22, PTRH2, PTS, PURA, QARS, QDPR, RAB18, RAB27A, RAB39B, RAB3GAP1, RAB3GAP2, RAD50, RARS2, RASA1, RAX, RBFOX1, RBM10, RBPJ, RD3, RDH12, REEP1, REEP2, RELN, REV3L, RFT1, RNASEH2A, RNASEH2B, RNASEH2C, RNASET2, RNF125, RNF168, RNF170, RNF216, ROGDI, RPE65, RPGRIP1, RPGRIP1L, RPIA, RRM2B, RTEL1, RTN2, RTN4IP1, RTTN, SACS, SAMD9L, SAMHD1, SASS6, SATB2, SCARB2, SCN1A, SCN1B, SCN2A, SCN4A, SCN8A, SCN9A, SCO1, SCO2, SCP2, SCYL1, SDCCAG8, SDHA, SDHAF1, SDHB, SDHD, SEMA3A, SEPSECS, SERAC1, SETD2, SETX, SGCE, SHANK3, SHH, SIGMAR1, SIK1, SIL1, SIX3, SKI, SLC12A5, SLC12A6, SLC13A5, SLC16A2, SLC17A5 , SLC19A2, SLC19A3, SLC1A3, SLC1A4, SLC20A2, SLC25A1, SLC25A12, SLC25A15, SLC25A22, SLC25A4, SLC25A46, SLC2A1, SLC2A3, SLC30A10, SLC33A1, SLC39A14, SLC39A4, SLC46A1, SLC52A2, SLC52A3, SLC6A1, SLC6A17, SLC6A19, SLC6A3, SLC6A8, SLC9A1, SLC9A6, SMAD4, SMARCA4, SMARCB1, SMC1A, SMPD1, SNAP25, SNCA, SNX14, SOD1, SORL1, SOST, SOX10, SOX2, SOX3, SOX6, SPAST, SPATA5, SPATA7, SPG11, SPG20, SPG21, SPG7, SPR, SPRY4, SPTAN1, SPTBN2, SQSTM1, SRD5A3, ST3GAL3, ST3GAL5, STAMBP, STAT4, STIL, STK11, STRADA, STUB1, STX11, STXBP1, STXBP2, SUCLA2, SUCLG1, SUFU, SUMF1, SUOX, SURF1, SYNE1, SYNGAP1, SYNJ1, SYT14, SYT2, TAC3, TACO1, TACR3, TAF1, TAF2, TARDBP, TBC1D20, TBC1D24, TBK1, TBX18, TCF4, TCN2, TCTN1, TCTN2, TDP1, TDP2, TEAD1, TECPR2, TECR, TERT, TFG, TGM6, TH, THAP1, THG1L, TIMM8A, TINF2, TK2, TLR4, TMEM138, TMEM216, TMEM231, TMEM237, TMEM240, TMEM5, TMEM67, TMEM70, TOP2A, TOR1A, TOR1AIP1, TPI1, TPK1, TPM2, TPM3, TPP1, TRAPPC11, TRAPPC9, TREM2, TREX1, TRIM32, TRNT1, TSEN2, TSEN34, TSEN54, TSFM, TTBK2, TTC19, TTC8, TTF1, TTPA, TTR, TUBA1A, TUBB, TUBB2A, TUBB2B, TUBB3, TUBB4A, TUBG1, TULP1, TUSC3, TYMP, TYROBP, UBA5, UBE3A, UBQLN2, UBTF, UCHL1, UNC13A, UNC13D, UNC80, UPB1, UQCC2, UQCC3, UQCRB, UQCRC2, UQCRQ, UROC1, UROD, USB1, USP8, VAMP1, VAPB, VARS2, VCP, VLDLR, VPS13A, VPS13B, VPS16, VPS35, VPS37A, VPS53, VRK1, VWA3B, VWF, WDPCP, WDR11, WDR45, WDR48, WDR62, WDR73, WDR81, WFS1, WNK1, WRAP53, WWOX, XPA, XPR1, XRCC1, XRCC4, YWHAE, ZC3H14, ZC4H2, ZFR, ZFYVE26, ZFYVE27, ZNF335, ZNF423, ZNF592
  • Molecular confirmation of a clinical diagnosis
  • To assist with decisions about treatment and management of individuals with ataxia
  • Next-Gen Sequencing

Ordering

J762
6 weeks
2-5 mL Blood - Lavender Top Tube
Dried Blood Spots | Buccal Swabs

Billing

81286x1, 81185x1, 81403x1, 81404x1, 81405x2, 81406x4, 81407x1, 81408x2
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Bird T. Hereditary Ataxia Overview. 1998 Oct 28 [Updated 2016 Nov 3]. In: Pagon RA, Adam MP, Ardinger HH, et al., editors. GeneReviews [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2016. Available from: https://www.ncbi.nlm.nih.gov/boo
  2. Finsterer et al. (2009) Can J Neurol Sci 36 (4):409-28 (PMID: 19650351)
  3. Jayadev et al. (2013) Genet. Med. 15 (9):673-83 (PMID: 23538602)
  4. Sandford et al. (2014) Genes (Basel) 5 (3):586-603 (PMID: 25055202)
  5. Durr et al. (2010) Lancet Neurol 9 (9):885-94 (PMID: 20723845)
  6. Embiruçu et al. (2009) Arq Neuropsiquiatr 67 (4):1143-56 (PMID: 20069237)
  7. Kalia et al. (2016) Genet. Med.: (PMID: 27854360)
  8. Nemeth et al. (2013) Brain 136 (Pt 10):3106-18 (PMID: 24030952)
  9. Sastry et al. Exome Sequencing Provides a Broad Evaluation and High Diagnostic Rate for Ataxia-Related Disorders [abstract and platform presentation] To be presented at the 2017 ACMG Annual Clinical Genetics Meeting, March 21-25, 2016 Phoenix, AZ
  10. Retterer et al. (2015) Genet. Med.: (PMID: 26633542)
Dystonia and Parkinsonism Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

ADAR, ADCY5, AFG3L2, ANO3, APTX, ARSA, ATM, ATP13A2, ATP1A3, ATP6AP2, ATP7B, C10orf2, C19orf12, CACNA1A, COASY, CP, CYP27A1, DCAF17, DLAT, DNAJC5, DNAJC6, FA2H, FBXO7, FTL, GBA, GCDH, GCH1, GLRA1, GNAL, KCNMA1, KMT2B, LRRK2, MARS2, MCOLN1, MRE11A, NKX2-1, NPC1, NPC2, PANK2, PARK2, PARK7, PDGFB, PINK1, PLA2G6, PNKD, PNKP, POLG, POLR3B, PRKRA, PRRT2, SCP2, SGCE, SLC16A2, SLC20A2, SLC2A1, SLC30A10, SLC6A3, SMPD1, SNCA, SPR, SYNJ1, TH, THAP1, TIMM8A, TOR1A, TOR1AIP1, TPK1, TRAPPC11, TUBB4A, VPS13A, VPS35, WDR45, XPR1
  • Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Assist with treatment/ management decisions
  • Recurrence risk assessment
  • Prenatal diagnosis for known familial pathogenic variant(s) in at-risk pregnancies IF appropriate
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis
  • Capillary Sequencing

Ordering

T402
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81185x1, 81404x4, 81405X2, 81406x2, 81408x1
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Dystonia Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

ADAR, ADCY5, AFG3L2, ANO3, APTX, ARSA, ATM, ATP13A2, ATP1A3, ATP7B, CACNA1A, COASY, CYP27A1, DCAF17, DLAT, FA2H, FTL, GCDH, GCH1, GLRA1, GNAL, KMT2B, MARS2, MRE11A, NKX2-1, NPC1, NPC2, PANK2, PDGFB, PLA2G6, PNKD, PNKP, POLR3B, PRKRA, PRRT2, SCP2, SGCE, SLC16A2, SLC20A2, SLC2A1, SLC30A10, SPR, SYNJ1, TH, THAP1, TIMM8A, TOR1A, TPK1, TRAPPC11, TUBB4A, VPS13A, WDR45, XPR1
  • Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Assist with treatment/ management decisions
  • Recurrence risk assessment
  • Prenatal diagnosis for known familial pathogenic variant(s) in at-risk pregnancies IF appropriate
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

T403
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81404x1, 81405x2, 81406x1
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Parkinson Disease Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

AFG3L2, ATP13A2, ATP6AP2, C10orf2, C19orf12, COASY, CP, CYP27A1, DNAJC5, DNAJC6, FBXO7, GBA, LRRK2, PARK2, PARK7, PINK1, PLA2G6, POLG, PRKRA, SLC16A2, SLC20A2, SLC6A3, SMPD1, SNCA, SYNJ1, VPS13A, VPS35, WDR45, XPR1
  • Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Assist with treatment/ management decisions
  • Recurrence risk assessment
  • Prenatal diagnosis for known familial pathogenic variant(s) in at-risk pregnancies IF appropriate
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis
  • Capillary Sequencing

Ordering

T401
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81404x2, 81405x2, 81406x2, 81408x1
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
GCH1 Gene Sequencing & Del/Dup

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Confirmation of a clinical diagnosis
  • Selection of appropriate treatment
  • Identification of at-risk family members
  • Capillary Sequencing
  • Deletion/Duplication Analysis

Ordering

527
3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81405x1, 81479x1
No
Yes
  • 270.1 Phenylketonuria [PKU], Hyperphenylalaninemia
  • 781 Symptoms involving nervous and musculoskeletal systems Excludes: depression NOS (311) disorders specifically relating to: back (724.0-724.9) hearing (388.0-389.9) joint (718.0-719.9) limb (729.0-729.9) neck (723.0-723.9) vision (368.0-369.9) pain in limb (729.5)
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Muller Y et Al., (1998) Neurogenetics 1:165-177.
  2. Ichinose H et Al., (1994) Nat Genet 8:236-242.
  3. Bandmann O et Al., (1996) Hum Molec Genet 5:403-406.
  4. Furukawa Y et Al., (1998) Ann Neurol 44: 10-16.
  5. Furukawa Y et Al., (1998) Neurology 50:1015-20.
  6. Muller U et Al., (2002) J Neural Transm 109:321-328
  7. Furukawa Y, (2004) Adv Neurol 94:127-138.
  8. Hagenah et Al., (2005) Neurology 64:908-911.
  9. Thony B and Blau N, (2006) Hum Mutat 27:870- 878.
  10. Zirn B et Al., (2008) J Neurol Neurosurg Psych 79:183-186.
  11. Clot F et Al., (2009) Brain 132: 1753-1763.
  12. Furukawa Y, (2009) Gene Reviews GTPCH1-Deficient DRD.
Tyrosine Hydroxylase Deficiency (TH)

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Capillary Sequencing
  • Deletion/Duplication Analysis

Ordering

TA78
3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81406x1
No
Yes
  • 348.3 Encephalopathy, not elsewhere classified
  • 780.6 Fever and other physiologic disturbances of temperature regulation
  • 251.2 Hypoglycemia, unspecified Hypoglycemia: NOS reactive spontaneous
  • 374.3 Ptosis of eyelid
  • 781 Symptoms involving nervous and musculoskeletal systems Excludes: depression NOS (311) disorders specifically relating to: back (724.0-724.9) hearing (388.0-389.9) joint (718.0-719.9) limb (729.0-729.9) neck (723.0-723.9) vision (368.0-369.9) pain in limb (729.5)
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. HGMD Professional 2010.3
  2. Willemsen et al., (2010) Brain 133:1810-1822
  3. Pons R et al., (2010) Mov Disord 25(8): 1086-90
  4. Zafeiriou et al., (2009) Mol Genet Metab 97:18-20
  5. Clot et al., (2009) Brain 132: 1753- 1763
  6. Swoboda (2008) TH Deficiency http://www.genetests.org
  7. Verbeek et al., (2007) Ann Neurol 62:422-426
  8. Ribases et al., (2007) Mol Genet Metab 92:274-277
  9. Schiller et al., (2004) Neurology 63:1524-1526
  10. Furukawa et al., (2001) Neurology 56:260-263
  11. Janssen et al., (2000) Ann Hum Genet 64:375-382
  12. Wevers et al., (1999) J Inher Metab Dis 22:364- 373
  13. Van den Heuvel et al., (1998) Hum Genet 102:644-6
GFAP Gene Sequencing

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Confirmation of a clinical diagnosis
  • Differentiation of Alexander disease from Canavan disease
  • Prenatal diagnosis in at-risk pregnancies
  • Capillary Sequencing

Ordering

218
3 weeks
2-5 mL Blood - Lavender Top Tube
Dried Blood Spots | Buccal Swabs

Billing

81405x1
No
Yes
  • 330 Cerebral degenerations usually manifest in childhood Use additional code to identify associated mental retardation
  • 742.4 Other specified anomalies of brain, Congenital cerebral cyst, Macroencephaly, Macrogyria, Megalencephaly, Multiple anomalies of brain NOS, Porencephaly Ulegyria
  • 330.8 Other specified cerebral degenerations in childhood, Alpers' disease or gray-matter degeneration, Infantile necrotizing encephalomyelopathy, Leigh's disease, Subacute necrotizing, encephalopathy or encephalomyelopathy
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Schuelke, M et al., Mutant NDUFV1 subunit of mitochondrial complex I causes leukodystrophy and myoclonic epilepsy. Nat Genet 21(3):260-1. 1999
  2. Brenner, M et al., Mutations in GFAP, encoding glial fibrillary acidic protein, are associated with Alexander disease Nature Genetics 27:117-120 (2001)
  3. Meins M et al., Infantile Alexander Disease: A GFAP Mutation in Monozygotic Twins and Novel Mutations in Two Other Patients Neuropediatrics 33:194-198 (2002)
  4. Rodriguez D et al., Infantile Alexander Disease: Spectrum of GFAP Mutations and Genotype-Phenotype Correlation Am J Hum Genet 69:1134-1140 (2001)
  5. Gorospe JR et al., Molecular findings in symptomatic and pre-symptomatic Alexander disease patients Neurology 58: 1494-1500 (2002)
NPC1/NPC2 Sequencing Panel

Forms and Documents

Test Info Sheet Test Requisition Form

Test Details

NPC1, NPC2
  • Confirmation of a clinical diagnosis
  • Carrier testing in unaffected family members
  • Prenatal diagnosis in families with known mutation
  • Capillary Sequencing

Ordering

581
4-5 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81406x1, 81404x1
No
Yes
  • 330.2 Cerebral degeneration in generalized lipidoses; Code first underlying disease, as: Fabry's disease (272.7), Gaucher's disease (272.7), Niemann-Pick disease (272.7), sphingolipidosis (272.7)
  • 272.2 Mixed hyperlipidemia, Broad- or floating-betalipoproteinemia, Combined hyperlipidemia, Elevated cholesterol with elevated triglycerides NEC, Fredrickson Type IIb or III hyperlipoproteinemia, Hypercholesterolemia with endogenous hyperglyceridemia, Hyperbetalipoproteinemia with prebetalipoproteinemia, Tubo-eruptive xanthoma Xanthoma tuberosum
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Millat et al., (2005) Mol Genet Metab 86:220-232
  2. Park et al., (2003) Hum Mut 22:313
  3. Verot et al., (2007) Clin Genet 71:320-30
  4. Sevin et al., (2007) Brain 130:120-133
  5. Fernandez-Valero et al., (2005) Clin Genet 68 :245-254

Neuromuscular Disorders

Hereditary Neuropathy Panel

Forms and Documents

Test Requisition Physician Guide Test Info Sheet

Test Details

AARS, AIFM1, ATL1, ATP7A, BSCL2, DNAJB2, DNM2, DNMT1, DYNC1H1, EGR2, FGD4, FIG4, GAN, GARS, GDAP1, GJB1, GLA, GNB4, HARS, HINT1, HSPB1, HSPB8, IGHMBP2, IKBKAP, INF2, KIF1A, KIF5A, LITAF, LMNA, LRSAM1, MFN2, MME, MORC2, MPZ, MTMR2, NDRG1, NEFL, NGF, NTRK1, PLEKHG5, PMP22, PRDM12, PRPS1, PRX, RAB7A, REEP1, RETREG1, SBF1, SBF2, SCN11A, SCN9A, SEPT9, SH3TC2, SLC12A6, SLC52A2, SLC52A3, SPTLC1, SPTLC2, TFG, TRIM2, TRPV4, TTR, WNK1, YARS
  • Molecular confirmation of a clinical diagnosis
  • To assist with decisions about treatment and management of individuals with neuropathy
  • Testing of at-risk relatives for specific known mutation(s) previously identified in an affected family member
  • Prenatal diagnosis for known familial mutation(s) in at-risk pregnancies
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

737
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81448x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Core CMT Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

GDAP1, GJB1, MFN2, MPZ, PMP22, SH3TC2
  • Molecular confirmation of a clinical diagnosis
  • To assist with decisions about treatment and management of individuals with neuropathy
  • Testing of at-risk relatives for specific known mutation(s) previously identified in an affected family member
  • Prenatal diagnosis for known familial mutation(s) in at-risk pregnancies
  • Deletion/Duplication Analysis
  • Next-Gen Sequencing

Ordering

884
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81448x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Siskind et al. (2013) Journal of genetic counseling 22 (4):422-36 (PMID: 23604902).
  2. Vallat et al. (2013) Current opinion in neurology 26 (5):473-80 (PMID: 23945280).
  3. Murphy et al. (2012) Journal of neurology, neurosurgery, and psychiatry 83 (7):706-10 (PMID: 22577229).
  4. Bird (Updated March 2014). Charcot-Marie-Tooth Hereditary Neuropathy Overview. In: GeneReviews at GeneTests: Medical Genetics Information Resource (database online). Copyright, University of Washington, Seattle. 1997-2010. Available at http://www.genete
  5. Bird (Updated February 2014). Charcot-Marie-Tooth Neuropathy Type 1. In: GeneReviews at GeneTests: Medical Genetics Information Resource (database online). Copyright, University of Washington, Seattle. 1997- 2010. Available at http://www.genetests.org
  6. Bird (Updated May 2010). Hereditary Neuropathy with Liability to Pressure Palsies. In: GeneReviews at GeneTests: Medical Genetics Information Resource (database online). Copyright, University of Washington, Seattle. 1997-2010. Available at http://www.ge
  7. Al-Thihli et al. (2008) American journal of medical genetics. Part A 146A (18):2412-6 (PMID: 18698610).
  8. Baets et al. (2011) Brain : a journal of neurology 134 (Pt 9):2664-76 (PMID: 21840889).
  9. Shy, et al. (2006) Journal of the neurological sciences 242 (1-2):55-66 (PMID: 16414078).
  10. Mazzeo et al. (2008) Acta neurologica Scandinavica 118 (5):328-32 (PMID: 18422810).
  11. Zuchner (Updated August 2013). Charcot-Marie-Tooth Neuropathy type 2A. In: GeneReviews at GeneTests: Medical Genetics Information Resource (database online). Copyright, University of Washington, Seattle. 1997- 2010. Available at http://www.genetests.org.
  12. Chung et al. (2006) Brain 129: 2103-2118.
  13. Verhoeven et al. (2006) Brain 129: 2093-2102.
  14. Bird (Updated March 2013). Charcot-Marie-Tooth Neuropathy X Type 1. In: GeneReviews at GeneTests: Medical Genetics Information Resource (database online). Copyright, University of Washington, Seattle. 1997- 2010. Available at http://www.genetests.org.
  15. Reilly et al. (2011) Journal of the peripheral nervous system: JPNS 16 (1):1-14 (PMID: 21504497).
  16. Saporta et al. (2011) Annals of neurology 69 (1):22-33 (PMID: 21280073).
Axonal CMT Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

AARS, AIFM1, BSCL2, DNAJB2, DNM2, DYNC1H1, GAN, GARS, GDAP1, GJB1, GNB4, HARS, HINT1, HSPB1, HSPB8, IGHMBP2, INF2, KIF5A, LMNA, LRSAM1, MFN2, MME, MORC2, MPZ, NEFL, PLEKHG5, PRPS1, RAB7A, SLC12A6, TRIM2, TRPV4, YARS
  • Molecular confirmation of a clinical diagnosis
  • To assist with decisions about treatment and management of individuals with neuropathy
  • Testing of at-risk relatives for specific mutation(s) previously identified in an affected family member
  • Prenatal diagnosis for known familial mutation(s) in at-risk pregnancies
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

885
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81448x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Demyelinating CMT Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

DNM2, EGR2, FGD4, FIG4, GDAP1, GJB1, GNB4, INF2, LITAF, MFN2, MPZ, MTMR2, NDRG1, NEFL, PLEKHG5, PMP22, PRPS1, PRX, SBF1, SBF2, SH3TC2, SLC12A6, YARS
  • Molecular confirmation of a clinical diagnosis
  • To assist with decisions about treatment and management of individuals with neuropathy
  • Testing of at-risk relatives for specific mutation(s) previously identified in an affected family member
  • Prenatal diagnosis for known familial mutation(s) in at-risk pregnancies
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

886
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81448x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Charcot-Marie-Tooth Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

AARS, AIFM1, BSCL2, DNAJB2, DNM2, DYNC1H1, EGR2, FGD4, FIG4, GAN, GARS, GDAP1, GJB1, GNB4, HARS, HINT1, HSPB1, HSPB8, IGHMBP2, INF2, KIF5A, LITAF, LMNA, LRSAM1, MFN2, MME, MORC2, MPZ, MTMR2, NDRG1, NEFL, PLEKHG5, PMP22, PRPS1, PRX, RAB7A, SBF1, SBF2, SH3TC2, SLC12A6, TRIM2, TRPV4, YARS
  • Molecular confirmation of a clinical diagnosis
  • To assist with decisions about treatment and management of individuals with neuropathy
  • Testing of at-risk relatives for specific mutation(s) previously identified in an affected family member
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

J778
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81448x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Hereditary Sensory and Autonomic Neuropathy Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

ATL1, DNMT1, IKBKAP, KIF1A, NGF, NTRK1, PRDM12, RAB7A, RETREG1, SCN11A, SCN9A, SPTLC1, SPTLC2, WNK1
  • Molecular confirmation of a clinical diagnosis
  • To assist with decisions about treatment and management of individuals with neuropathy
  • Testing of at-risk relatives for specific mutation(s) previously identified in an affected family member
  • Prenatal diagnosis for known familial mutation(s) in at-risk pregnancies
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

T399
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81448x1
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
PMP22 Del/Dup

Forms and Documents

Test Requisition Test Info Sheet Physician Guide

Test Details

  • Confirmation of clinical diagnosis
  • Identification of at-risk family members
  • Can assist with management/treatment decisions
  • Deletion/Duplication Analysis

Ordering

742
2 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81324x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Bird (Updated May 2010). Hereditary Neuropathy with Liability to Pressure Palsies. In: GeneReviews at GeneTests: Medical Genetics Information Resource (database online). Copyright, University of Washington, Seattle. 1997-2010.
  2. Bird (Updated July 2013). Charcot-Marie-Tooth Hereditary Neuropathy Overview. In: GeneReviews at GeneTests: Medical Genetics Information Resource (database online). Copyright, University of Washington, Seattle. 1997-2010.
  3. Li, J (2012) Semin Neurol. 32(3): 204-214.
  4. Nelis et al. (2006) Eur J Hum Genet 4(1): 25-33.
  5. Siskind et al. (2013) J Genet Counsel 22:422-436.
PMP22 Gene Sequencing

Forms and Documents

Test Requisition Test Info Sheet

Test Details

  • Confirmation of clinical diagnosis
  • Identification of at-risk family members
  • Can assist with management/treatment decisions
  • Next-Gen Sequencing

Ordering

888
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81325x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Bird (Updated May 2010). Hereditary Neuropathy with Liability to Pressure Palsies. In: GeneReviews at GeneTests: Medical Genetics Information Resource (database online). Copyright, University of Washington, Seattle. 1997-2010. Available at http://www.ge
  2. Bird (Updated July 2013). Charcot-Marie-Tooth Hereditary Neuropathy Overview. In: GeneReviews at GeneTests: Medical Genetics Information Resource (database online). Copyright, University of Washington, Seattle. 1997-2010. Available at http://www.genetes
  3. Li, J (2012) Semin Neurol. 32(3): 204-214.
  4. Nelis et al. (2006) Eur J Hum Genet 4(1): 25-33
  5. Siskind et al. (2013) J Genet Counsel 22:422-436.
TTR Gene Sequencing

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Confirmation of a clinical diagnosis
  • Differentiation between cardiac amyloidosis and other cardiomypopathies
  • Carrier testing in at-risk family members
  • Prenatal diagnosis in families with a known pathogenic variant
  • Capillary Sequencing

Ordering

363
4-5 weeks
2-5 mL Blood - Lavender Top Tube
Dried Blood Spots | Buccal Swabs

Billing

81404x1
Yes
Yes
  • 277.3 Amyloidosis
  • 425.7 Nutritional and metabolic cardiomyopathy; Code first underlying disease, as: amyloidosis (277.30-277.39), beriberi (265.0), cardiac glycogenosis (271.0), mucopolysaccharidosis (277.5), thyrotoxicosis (242.0-242.9)
  • 277.39 Other amyloidosis, Hereditary cardiac amyloidosi,s Inherited systemic amyloidosis, Neuropathic (Portuguese) (Swiss) amyloidosis, Secondary amyloidosis
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Juvenile Amyotrophic Lateral Sclerosis Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

ALDH18A1, ALS2, BICD2, BSCL2, C19orf12, FUS, HEXA, SETX, SIGMAR1, SLC52A2, SLC52A3, SOD1, SPAST, SPG11, UBQLN2, ZFYVE26
  • Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Assist with treatment/ management decisions
  • Recurrence risk assessment
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

T815
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81404x1; 81405x1; 81406x2; 81407x1
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
C9orf72 Repeat Analysis

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Molecular confirmation of a clinical diagnosis

SAMPLES NOT ACCEPTED FROM INDIVIDUALS UNDER 18 YEARS OF AGE.

  • PCR Fragment Analysis

Ordering

J805
3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81479x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Mackenzie et al. (2014) Acta Neuropathol. 127 (3):347-57 (PMID: 24356984)
  2. White et al. (2016) Curr. Opin. Neurol. 29 (5):557-64 (PMID: 27538057)
  3. Cruts M, Engelborghs S, van der Zee J, et al. C9orf72-Related Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. 2015 Jan 8. In: Pagon RA, Adam MP, Ardinger HH, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seat
  4. Cruts et al. (2013) Trends Neurosci. 36 (8):450-9 (PMID: 23746459)
  5. van der Zee et al. (2013) Hum. Mutat. 34 (2):363-73 (PMID: 23111906)
  6. Gijselinck et al. (2016) Mol. Psychiatry 21 (8):1112-24 (PMID: 26481318)
  7. Akimoto et al. (2014) J. Med. Genet. 51 (6):419-24 (PMID: 24706941)
  8. Ross LF, Saal HM, David KL, Anderson RR; American Academy of Pediatrics; American College of Medical Genetics and Genomics. Technical report: Ethical and policy issues in genetic testing and screening of children. Genet Med. 2013 Mar;15(3):234-45.
  9. COMMITTEE ON BIOETHICS, COMMITTEE ON GENETICS, AND THE AMERICAN COLLEGE OF MEDICAL GENETICS AND GENOMICS SOCIAL, ETHICAL, AND LEGAL ISSUES COMMITTEE. POLICY STATEMENT. Ethical and Policy Issues in Genetic Testing and Screening of Children. Pediatrics. 201
  10. American Society of Human Genetics Board of Directors, American College of Medical Genetics Board of Directors. Points to Consider: Ethical, Legal, and Psychosocial Implications of Genetic Testing in Children and Adolescents. Am J Hum Genet. 1995 Nov;57(5
  11. NSGC Executive Office. Genetic Testing of Minors for Adult-Onset Conditions Position Statement (Adopted 2012).
  12. AMA Code of Medical Ethics Opinion 2.138 - Genetic Testing of Children. Issued June 1996.
  13. Botkin JR et al. Points to Consider: Ethical, Legal, and Psychosocial Implications of Genetic Testing in Children and Adolescents. American Journal Of Human Genetics. 2015 Jul 02 97(1):6-21.2614044
Amyotrophic Lateral Sclerosis / Frontotemporal Lobar Degeneration Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

ALS2, ANG, CHCHD10, CHMP2B, FUS, GRN, HNRNPA2B1, MAPT, MATR3, OPTN, PFN1, PRPH, SETX, SLC52A3, SOD1, SPG11, SQSTM1, TAF15, TARDBP, TBK1, TUBA4A, UBQLN2, VAPB, VCP
  • Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Assist with treatment/ management decisions
  • Recurrence risk assessment

SAMPLES NOT ACCEPTED FROM INDIVIDUALS UNDER 18 YEARS OF AGE.

  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

T404
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81403x1, 81404x1, 81405x1, 81406x2, 81407x1
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
AR Repeat Analysis

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Molecular confirmation of a clinical diagnosis
  • PCR Fragment Analysis

Ordering

820
3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81401x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Neuromuscular Disorders Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

ACTA1, ANO5, ASAH1, ATP2A1, B3GALNT2, B4GAT1, BAG3, BICD2, BIN1, BVES, CACNA1S, CAPN3, CAV3, CCDC78, CFL2, CHKB, CLCN1, CNTN1, COL12A1, COL6A1, COL6A2, COL6A3, CRYAB, DAG1, DES, DMD, DNAJB2, DNAJB6, DNM2, DOK7, DPM1, DPM2, DPM3, DYNC1H1, DYSF, EGR2, EMD, FHL1, FKRP, FKTN, FLNC, GAA, GBE1, GMPPB, GNE, IGHMBP2, ISPD, ITGA7, KBTBD13, KLHL40, KLHL41, LAMA2, LAMP2, LARGE, LDB3, LMNA, LMOD3, MEGF10, MICU1, MTM1, MYH2, MYH7, MYOT, NEB, PHKA1, PLEC, PLEKHG5, POMGNT1, POMK, POMT1, POMT2, PYGM, RYR1, SCN4A, SEPN1, SGCA, SGCB, SGCD, SGCG, SIL1, SLC52A2, SLC52A3, SYNE1, TCAP, TMEM5, TNNI2, TNNT1, TNPO3, TOR1AIP1, TPM2, TPM3, TRAPPC11, TRIM32, TRIP4, TRPV4, TTN, UBA1, VCP, VRK1
  • Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Assist with treatment/ management decisions
  • Recurrence risk assessment
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

889
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81407x1, 81408x2, 81161x1, 81405x2, 81406x2, 81404x3
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Limb-Girdle Muscular Dystrophy Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

ANO5, BVES, CAPN3, CAV3, DES, DMD, DNAJB6, DOK7, DYSF, FKRP, FKTN, GAA, GMPPB, LMNA, MYOT, POMGNT1, POMK, POMT1, POMT2, SGCA, SGCB, SGCD, SGCG, TCAP, TNPO3, TOR1AIP1, TRAPPC11, TRIM32, TTN, VCP
  • Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Assist with management/treatment decisions
  • Recurrence risk
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

890
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81405x2, 81406x2, 81408x2, 81161x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Syndromic Congenital Muscular Dystrophy Panel (SCMD)

Forms and Documents

Test Requisition Test Info Sheet

Test Details

B3GALNT2, B4GAT1, DAG1, DPM1, DPM2, DPM3, FKRP, FKTN, GMPPB, ISPD, ITGA7, LARGE, LMNA, POMGNT1, POMK, POMT1, POMT2, TMEM5, VRK1
  • Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Assist with management/treatment decisions
  • Recurrence risk
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

891
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81404x1, 81405x2, 81406x2, 81479x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Congenital Myopathy and Muscular Dystrophy Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

ACTA1, BICD2, CCDC78, CFL2, CHKB, COL12A1, COL6A1, COL6A2, COL6A3, DYNC1H1, FKRP, FKTN, GBE1, IGHMBP2, ITGA7, KBTBD13, KLHL40, KLHL41, LAMA2, LMNA, LMOD3, MEGF10, MICU1, MTM1, NEB, RYR1, SEPN1, TNNT1, TPM2, TPM3, TRIP4, TRPV4, UBA1, VRK1
  • Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Assist with management/treatment decisions
  • Recurrence risk
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

892
6 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81404x1, 81405x1, 81406x2, 81407x1, 81408x1, 81479X1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Myofibrillar Myopathy Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

BAG3, CRYAB, DES, DNAJB6, FHL1, FLNC, LDB3, MYOT
  • Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Assist with management/treatment decisions
  • Recurrence risk
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

893
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81404x1, 81405x2, 81406x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Duchenne/Becker MD (DMD) Del/Dup

Forms and Documents

Test Requisition Test Info Sheet

Test Details

  • Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Recurrence risk
  • Assist with management/treatment decisions
  • Deletion/Duplication Analysis

Ordering

787
2-3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81161x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Aartsma-Rus et al. (2006) Ann N Y Acad Sci. 1082:74–6.
  2. Barbujani et al. Segregation analysis of 1885 DMD families: significant departure from the expected proportion of sporadic cases. Hum Genet 1990: 84: 522-6.
  3. Bennett (2004) Pharmacogenomics. 5(4):433-8.
  4. Bushby et al., (1991) Lancet (337):1022–4.
  5. Callis et al. (2010). Expert Rev Mol Diagn 10:329-351.
  6. Darras et al. Dystrophinopathies. 2000 Sep 5 [Updated 2011 Nov 23]. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2014. Available at http://www.genetests.org.
  7. del Gaudio et al., Hum Mutat 2008 29:1100-1107. PMID 18752307
  8. Dooley et al. (2010) Clin Pediatr (Phila) 49:177–9.
  9. Flanigan et al. (2003) Am J Hum Gen 72: 931-945.Hershberger et al. (Updated [3/2009]). Dilated Cardiomyopathy Overview. In: GeneReviews at GeneTests Medical Genetics Information Resource (database online).
  10. Tangsrud & Halvorsen (1989) Acta Paediatr Scand. 78:100–3.
  11. Tuffery-Giraud et al. (2009) Am J Hum Gen 30:934-945.
Duchenne/Becker MD (DMD) Gene Sequencing

Forms and Documents

Test Requisition Test Info Sheet

Test Details

  • Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Recurrence risk
  • Assist with management/treatment decisions
  • Next-Gen Sequencing

Ordering

786
4 weeks
2-5 mL Blood - Lavender Top Tube
Dried Blood Spots | Buccal Swabs

Billing

81408x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Aartsma-Rus et al. (2006) Ann N Y Acad Sci. 1082:74–6.
  2. Barbujani et al. Segregation analysis of 1885 DMD families: significant departure from the expected proportion of sporadic cases. Hum Genet 1990: 84: 522-6.
  3. Bennett (2004) Pharmacogenomics. 5(4):433-8.
  4. Bushby et al., (1991) Lancet (337):1022–4.
  5. Callis et al. (2010). Expert Rev Mol Diagn 10:329-351.
  6. Callis et al. (2010). Expert Rev Mol Diagn 10:329-351.
  7. del Gaudio et al., Hum Mutat 2008 29:1100-1107. PMID 18752307
  8. Dooley et al. (2010) Clin Pediatr (Phila) 49:177–9.
  9. Flanigan et al. (2003) Am J Hum Gen 72: 931-945.Hershberger et al. (Updated [3/2009]). Dilated Cardiomyopathy Overview. In: GeneReviews at GeneTests Medical Genetics Information Resource (database online).
  10. Tangsrud & Halvorsen (1989) Acta Paediatr Scand. 78:100–3.
  11. Tuffery-Giraud et al. (2009) Am J Hum Gen 30:934-945.
Spinal Muscular Atrophy and Related Disorders Panel
Dosage Analysis of SMN1 and SMN2

Forms and Documents

Test Requisition Test Info Sheet

Test Details

SMN1, SMN2
  • ​Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Assist with treatment/ management decisions
  • Recurrence risk assessment
  • MLPA

Ordering

T789
3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81329x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
DMPK Repeat Analysis

Forms and Documents

Test Requisition Test Info Sheet

Test Details

  • Molecular confirmation of a clinical diagnosis
  • PCR Fragment Analysis

Ordering

818
3 weeks
2-5 mL Blood – Lavender Top Tube.
NOTE: if ordering reflex to Southern Blot analysis, 10-15 mL of blood is required for testing.
Buccal Swabs

Billing

81234x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Arsenault et al. (2006) Clinical characteristics of myotonic dystrophy type 1 patients with small CTG expansions. Neuro 66:1248-50.
  2. Bird TD. Myotonic Dystrophy Type 1. 1999 Sep 17 [Updated 2013 May 16]. In: Pagon RA, Adam MP, Bird TD, et al., editors. GeneReviews™ [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2013. Available from: http://www.ncbi.nlm.nih.gov/books/
  3. Dalton JC, Ranum LPW, Day JW. Myotonic Dystrophy Type 2. 2006 Sep 21 [Updated 2013 Jul 3]. In: Pagon RA, Adam MP, Bird TD, et al., editors. GeneReviews™ [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2013. Available from: http://www.ncb
  4. Day JW, Ricker K, Jacobsen JF, Rasmussen LJ, Dick KA, Kress W, Schneider C, Koch MC, Beilman GJ, Harrison AR, Dalton JC, Ranum LP. Myotonic dystrophy type 2: molecular, diagnostic and clinical spectrum. Neurology. 2003;60:657–64.
  5. Liquori et al. (2001). Myotonic dystrophy type 2 caused by a CCTG expansion in intron 1 of ZNF9. Sci 293:864-7.
  6. Logigian et al. (2005) Quantitative analysis of the “warm-up” phenomenon in myotoc dysrphy type 1. Muscel Nerve 32:35-42.
  7. Sternberg D, Tabti N, Hainque B, et al. Hypokalemic Periodic Paralysis. 2002 Apr 30 [Updated 2009 Apr 28]. In: Pagon RA, Adam MP, Bird TD, et al., editors. GeneReviews™ [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2013. Available from
  8. Suominen et al. (2011). Population frequency of myotonic dystrophy: higher than expected frequency of myotonic dystrophy type 2 (DM2) mutation in Finland. Eur J Hum Genet 19: 776-82.
  9. Udd et al. (2010) Myotonic dystrophy type 2 (DM2) and related disorders report of the 180th ENMC workshop including guidelines on diagnostics and management 3-5 December 2010, Naarden, The Netherlands. Neuromuscl Disord 21: 443-50.
  10. Yotova et al. (2005) Anatomy of a founder effect: myotonic dystrophy in Northeastern Quebec. Hum Genet 117:177-87.
CNBP Repeat Analysis

Forms and Documents

Test Requisition Test Info Sheet

Test Details

  • Molecular confirmation of a clinical diagnosis
  • PCR Fragment Analysis

Ordering

819
3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81187x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Arsenault et al. (2006) Clinical characteristics of myotonic dystrophy type 1 patients with small CTG expansions. Neuro 66:1248-50.
  2. Bird TD. Myotonic Dystrophy Type 1. 1999 Sep 17 [Updated 2013 May 16]. In: Pagon RA, Adam MP, Bird TD, et al., editors. GeneReviews™ [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2013. Available from: http://www.ncbi.nlm.nih.gov/books/
  3. Dalton JC, Ranum LPW, Day JW. Myotonic Dystrophy Type 2. 2006 Sep 21 [Updated 2013 Jul 3]. In: Pagon RA, Adam MP, Bird TD, et al., editors. GeneReviews™ [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2013. Available from: http://www.ncb
  4. Day JW, Ricker K, Jacobsen JF, Rasmussen LJ, Dick KA, Kress W, Schneider C, Koch MC, Beilman GJ, Harrison AR, Dalton JC, Ranum LP. Myotonic dystrophy type 2: molecular, diagnostic and clinical spectrum. Neurology. 2003;60:657–64.
  5. Liquori et al. (2001). Myotonic dystrophy type 2 caused by a CCTG expansion in intron 1 of ZNF9. Sci 293:864-7.
  6. Logigian et al. (2005) Quantitative analysis of the “warm-up” phenomenon in myotoc dysrphy type 1. Muscel Nerve 32:35-42.
  7. Sternberg D, Tabti N, Hainque B, et al. Hypokalemic Periodic Paralysis. 2002 Apr 30 [Updated 2009 Apr 28]. In: Pagon RA, Adam MP, Bird TD, et al., editors. GeneReviews™ [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2013. Available from
  8. Suominen et al. (2011). Population frequency of myotonic dystrophy: higher than expected frequency of myotonic dystrophy type 2 (DM2) mutation in Finland. Eur J Hum Genet 19: 776-82.
  9. Udd et al. (2010) Myotonic dystrophy type 2 (DM2) and related disorders report of the 180th ENMC workshop including guidelines on diagnostics and management 3-5 December 2010, Naarden, The Netherlands. Neuromuscl Disord 21: 443-50.
  10. Yotova et al. (2005) Anatomy of a founder effect: myotonic dystrophy in Northeastern Quebec. Hum Genet 117:177-87.
PABPN1 Repeat Analysis

Forms and Documents

Test Requisition Test Info Sheet

Test Details

  • Molecular confirmation of a clinical diagnosis
  • Capillary Sequencing

Ordering

743
3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81312x1
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Anvar et al. (2011) Deregulation of the ubiquitin-proteasome system in the predominant molecular pathology in OPMD animal models and patients. Skelet Muscle 1:15.
  2. Askanas et al. (1995) New advances in the understanding of sporadic inclusion-body myositis and hereditary inclusion-body myopathies. Curr Opin Rheumatol. 7:486-96.
  3. Becher et al. (2001) Oculopharyngeal muscular dystrophy in Hispanic New Mexicans. JAMA 286:2437-40.
  4. Blumen et al. Epidemiology and inheritance of oculophyaryngeal muscular dystrophy in Israel. Neuromuscul Disord 6:S38-40.
  5. Brais et al. (1998) Short GCG expansion in the PABP3 gene cause oculopharyngeal muscular dystrophy. Nat Genet 18:164-7.
  6. Trollet C, Gidaro T, Klein P, et al. Oculopharyngeal Muscular Dystrophy. 2001 Mar 8 [Updated 2014 Feb 20]. In: Pagon RA, Adam MP, Ardinger HH, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2014. Available
Congenital Myasthenia Syndromes Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

AGRN, ALG14, ALG2, CHAT, CHRNA1, CHRNB1, CHRND, CHRNE, COLQ, DOK7, DPAGT1, GFPT1, GMPPB, LRP4, MUSK, RAPSN, SCN4A, SYT2
  • Molecular confirmation of a clinical diagnosis.
  • To assist with decisions regarding treatment and management of individuals with congenital myasthenia.
  • Testing of at-risk relatives for specific known pathogenic variant(s) previously identified in an affected family
  • member.
  • Prenatal diagnosis for known familial pathogenic variant(s) in at-risk pregnancies.
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

945
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81406x1, 81479x1
No
No
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
APOE ε4 Alzheimer Disease Risk

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Evaluate for the ε4 risk allele in the APOE gene
  • Some studies have shown that APOE ε4 carriers are at increased risk for developing AD and increased risk for developing the disease at an earlier age.

SAMPLES NOT ACCEPTED FROM INDIVIDUALS UNDER 18 YEARS OF AGE.

  • Capillary Sequencing

Ordering

TF72
2 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs | Extracted DNA

Billing

81401x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Arthrogryposis Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

ACTA1, AGRN, ALG14, ALG2, ALG3, ANTXR2, BICD2, BIN1, CHAT, CHMP1A, CHRNA1, CHRNB1, CHRND, CHRNE, CHRNG, CHST14, CNTN1, CNTNAP1, COL6A1, COL6A2, COL6A3, COLQ, DHCR24, DNM2, DOK7, DPAGT1, ECEL1, EGR2, ERBB3, ERCC1, ERCC5, ERCC6, EXOSC3, FBN1, FBN2, FKBP10, FKRP, FKTN, FLVCR2, GBA, GBE1, GFPT1, GLE1, GMPPB, IGHMBP2, KAT6B, KLHL40, KLHL41, LMNA, LMOD3, LRP4, MAGEL2, MPZ, MTM1, MUSK, MYBPC1, MYH2, MYH3, MYH8, NALCN, NEB, PIEZO2, PIP5K1C, PLOD2, RAPSN, RIPK4, RYR1, SCARF2, SCN4A, SELENON, SKI, SLC35A3, SLC39A13, SLC5A7, SOX10, SYNE1, SYT2, TGFB3, TNNI2, TNNT1, TNNT3, TPM2, TPM3, TRIP4, TRPV4, TSEN54, TTN, UBA1, VIPAS39, VPS33B, ZC4H2
  • Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Assist with management/treatment decisions
  • Recurrence risk assessment
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

TG80
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs | Extracted DNA

Billing

81479x1
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Distal Arthrogryposis Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

CHST14, ECEL1, FBN2, MYBPC1, MYH2, MYH3, MYH8, NALCN, PIEZO2, TNNI2, TNNT3, TPM2
  • Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Assist with management/treatment decisions
  • Recurrence risk assessment
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

TG79
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs | Extracted DNA

Billing

81479x1
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Focused Arthrogryposis Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

BICD2, CHRNG, CHST14, CNTNAP1, ECEL1, FBN2, GLE1, MYH3, NALCN, PIEZO2, TNNI2, TNNT3, TPM2, ZC4H2
  • Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Assist with management/treatment decisions
  • Recurrence risk assessment
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

TG76
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs | Extracted DNA

Billing

81479x1
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Periodic Paralysis Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

ATP1A2, CACNA1S, CLCN1, KCNJ2, KCNJ5, RYR1, SCN4A, SCNN1A, SLC12A3
  • Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Assist with treatment/management decisions
  • Recurrence risk assessment

Ordering

TG81
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs | Extracted DNA

Billing

81403x1; 81406x2; 81407x1; 81408x1
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Myotonia Panel

Forms and Documents

Test Requisition Test Info Sheet

Test Details

ATP2A1, CACNA1S, CAV3, CLCN1, CNBP, DMPK, GLRA1, HINT1, PTRF, SCN4A
  • Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Assist with treatment/management decisions
  • Recurrence risk assessment
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis
  • PCR Fragment Analysis

Ordering

TG82
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs | Extracted DNA

Billing

81187x1; 81234x1; 81404x1; 81406x2
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Congenital Hypotonia Evaluation

Forms and Documents

Test Requisition Test Info Sheet

Test Details

DMPK, SMN1, SMN2
  • Molecular confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Assist with treatment/management decisions
  • Recurrence risk assessment
  • PCR Fragment Analysis
  • Deletion/Duplication Analysis
  • Dosage Analysis

Ordering

TG78
2-3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs | Extracted DNA

Billing

81234x1; 81329x1; 81331x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Congenital Hypotonia Xpanded Panel

Forms and Documents

Test Requisition Test Info Sheet Gene List

Test Details

  • Identification of at-risk family members
  • Assist with treatment/management decisions
  • Recurrence risk assessment
  • Next-Gen Sequencing

Ordering

TG77
6 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs | Extracted DNA

Billing

81175x1; 81185x1; 81302x1; 81321x1; 81404x1; 81406x2; 81408x2
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

Single-Gene & Other Neurological Disorders Testing

Allgrove (Triple-A) Syndrome (AAAS)

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Confirmation of a clinical diagnosis
  • Carrier testing in unaffected family members
  • Recurrence risk calculation
  • Prenatal diagnosis in families with an affected child and known mutation(s)
  • Capillary Sequencing
  • Deletion/Duplication Analysis

Ordering

TA56
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81479x1
No
Yes
  • 255.4 Corticoadrenal insufficiency
  • 530 Diseases of esophagus Excludes: esophageal varices (456.0-456.2)
  • 337 Disorders of the autonomic nervous system Includes: disorders of peripheral autonomic, sympathetic, parasympathetic, or vegetative system Excludes: familial dysautonomia [Riley-Day syndrome] (742.8)
  • 356 Hereditary and idiopathic peripheral neuropathy
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Houlden H et al. (2002) Brain 125: 2681-90
  2. Qin K et al., (2007) Mol Genet Metab 92(4):359-63
  3. Milenkovic T et al., (2010)Eur J Pediatr. 169(11):1323-8
  4. Sandrini F et al., (2001) J Clin Endocrinol. 86: 5433-7
  5. Brooks BP et al., (2005) Clin Genet. 68: 215-21
ABCD1 Gene Sequencing & Del/Dup

Forms and Documents

Test Requisition Test Info Sheet

Test Details

ABCD1
  • Molecular confirmation of a clinical diagnosis.
  • Testing of patients suspected of having X-linked adrenoleukodystrophy.
  • Prenatal diagnosis for known familial mutation(s) in at-risk pregnancies
  • Capillary Sequencing
  • MLPA

Ordering

J975
4 weeks
2-5 mL Blood - Lavender Top Tube
Not Recommended. For more information, please contact your sales representative, or GeneDx Customer Service at (888) 729-1206 or zebras@genedx.com.

Billing

81405x1; 81479x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Engelen M. et al, (2012) Orphanet J Rare Dis 7:51 PMID: 22889154
  2. Raymond GV, Moser AB, Fatemi A. X-Linked Adrenoleukodystrophy. 1999 Mar 26 [Updated 2018 Feb 15]. In: Adam MP, Ardinger HH, Pagon RA, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2018.
  3. Moser H. et al, (1997) Brain 120:1485-1508 PMID: 9278636
  4. Van Geel B. et al, (2001) Ann Neurol 49(2): 186-194 PMID: 11220738
  5. Moser A. et al, (1999) Ann Neurol 45(1):100-110 PMID: 9894883
  6. Horn M. et al, (2013) Pediatr Neurol (3):212-219 PMID: 23419472
  7. Kemper A. et al, (2017) Genet Med 19(1):121-126 PMID: 27337030
  8. Vogel B. et al, (2015) Mol Genet Metab 114(4):599-603 PMID: 25724074
  9. Kemp S. et al, (2001) Human Mutation 18: 499-515 PMID: 11748843
  10. Wang Y. et al, (2011) Mol Genet Metab 104(1-2):160-166 PMID: 21700483
  11. Berger J. et al, (1994) Biochem Biophys Res Commun 205(3):1638-1643 PMID: 7811247
  12. Pan H. et al, (2005) Pediatr Neurol 33(2):114-120 PMID: 16087056
  13. Bezman L. et al, (2001) Ann Neurol 49(4):512-517 PMID: 11310629
  14. Coll M. et al, (2005) Clin Genet 67:418-424 PMID: 15811009
  15. Kok F. et al, (1995) Human Mutation 6104-6115 PMID: 7581394
ACADVL Gene Sequencing

Forms and Documents

Test Info Sheet Test Requisition Form

Test Details

  • Diagnostic confirmation
  • Carrier testing
  • Prenatal diagnosis in at risk pregnancies
  • Capillary Sequencing

Ordering

270
4-5 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81406x1
No
Yes
  • 277.85 Disorders of fatty acid oxidation, Carnitine palmitoyltransferase deficiencies, Glutaric aciduria type II, Long chain 3-hydroxyacyl CoA dehydrogenase deficiency (LCHAD), Long chain/very long chain acyl CoA dehydrogenase deficiency, Medium chain acyl CoA dehydrogenase deficiency (MCAD), Short chain acyl CoA dehydrogenase deficiency (SCAD)
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Gregersen, N. et al, (2001) Hum Mutat 18:169-189
  2. Mathur, A. et al, (1999) Circulation 99:1337-1343
  3. Andresen, B.S. et al, (1999) Am J Hum Genet 64:479-494
  4. Liebig, M. et al, (2006) Pediatrics 118:1065-1069
AGS Panel

Forms and Documents

Test Info Sheet Test Requisition

Test Details

RNASEH2A, RNASEH2B, RNASEH2C, TREX1
  • Confirmation of a clinical diagnosis
  • Development of an appropriate management plan
  • Prenatal diagnosis in families with a defined mutation
  • Carrier testing
  • Capillary Sequencing

Ordering

547
3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81479x1
No
Yes
  • 333.6 Genetic torsion dystonia Dystonia: deformans progressiva, musculorum deformans (Schwalbe-), Ziehen-Oppenheim disease
  • 779 Other and ill-defined conditions originating in the perinatal period
  • 333 Other extrapyramidal disease and abnormal movement disorders Includes: other forms of extrapyramidal, basal ganglia, or striatopallidal disease Excludes: abnormal movements of head NOS (781.0) sleep related movement disorders (327.51-327.59)
  • 315.9 Unspecified delay in development, Developmental disorder NOS, Learning disorder NOS
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Lebon et al., (1988) J Neurol Sci 84:201-208
  2. Bonnemann et al., (1992). Neuropediatrics. 23:157-161
  3. Tolmie et al., (1995) J Med Genet. 32: 881-884
  4. Goutieres et al., (1998) Ann Neurol, 1998. 44:900-907.
  5. Kuijpers et al., (2002) Eur J Paediatr Neurol 6 Suppl A: A59-64; discussion A65-6, A77-86.
  6. Crow et al., (2008) Dev Med Child Neurol. 50:410-416.
  7. Aicardi, J. and F. Goutieres, (2000) Neuropediatrics 31:113.
  8. Giroud et al., (1986) Childs Nerv Syst 2:47-48.
  9. Rice, G., et al., (2007) Am J Hum Genet 80:811-815
KBG Syndrome (ANKRD11)

Forms and Documents

Test Requisition Test Info Sheet

Test Details

  • Confirmation of a clinical diagnosis
  • Carrier testing for individuals with a known familial ANKRD11 mutation
  • Prenatal diagnosis in at-risk pregnancies
  • Capillary Sequencing
  • Deletion/Duplication Analysis

Ordering

TB13
3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81479x1
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. K.L. Skjei et al., “KBG Syndrome: Reports of Twins, Neurological Characteristics, and Delineation of Diagnostic Criteria”. Am J Med Genet, Part A Vol. 143A: 292-300 (2007).
  2. S. Sacharow et al., “Familial 16q24.3 Microdeletion Involving ANKRD11 Causes a KBG-Like Syndrome”. Am J of Med Genet Part A Vol. 158A: 547-552 (2012).
  3. M.H. Willemsen et al., “Identification of ANKRD11 and ZNF778 as candidate genes for autism and variable cognitive impairment in the novel 16q24.3 microdeletion syndrome”. Eur J of Human Genet Vol 18: 429-435. (2010)
  4. M. Isrie et al., “Haploinsufficiency of ANKRD11 causes mild cognitive impairment, short stature and minor dysmorphisms”. Eur J of Hum Genet Vol 20: 131-133 (2012).
  5. E.L. Youngs et al., “ANKRD11 gene deletion in a 17-year-old male”. Clinical Dysmorphology Vol 20: 170- 171. (2011)
  6. F. Brancati et al., “KBG syndrome in a cohort of Italian patients”. Am J Med Genet Part A Vol. 131A: 144- 149 (2004).
  7. A. Sirmaci et al., “Mutations in ANKRD11 Cause KBG Syndrome, Characterized by Intellectual Disability, Skeletal Malformations, and Macrodontia”. Am J Hum Genet Vol 89: 289-294 (2011).
  8. A. Zhang et al., “Identification of a novel family of ankyrin repeats containing cofactors for p160 nuclear receptor coactivators”. J Biol. Chem Vol. 279: 33799-33805 (2004).
  9. A. Zhang et al., “Characterization of transcriptional regulatory domains of ankyrin repeat cofactor-1”. Biochemical and Biophysical Research Communications Vol.358: 1034–1040 (2007).
BTD Gene Sequencing

Forms and Documents

Test Info Sheet Test Requisition Form

Test Details

  • Confirmation of biochemical diagnosis
  • Carrier testing
  • Prenatal diagnosis in at risk pregnancies
  • Capillary Sequencing

Ordering

294
4-5 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81404x1
No
Yes
  • 277.8 Other specified disorders of metabolism
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Hymes, et al, (2001) Hum Mutat 18:375-381
  2. Wolf, et al, (2002) Molec Genet Metab 77:108-111
  3. Milankovics, et al, (2007) Molec Genet Metab 90:345-348
  4. Wolf, et al (2005) Hum Mutat 25:413
  5. Norrgard, et al (1999) Pediatr Res 46:20-27
  6. Pomponio, et al, (1997) Hum Genet 99:506-12
  7. Dobrowolski, et al, (2003) Molec Genet Metab 78:100-107
CPT2 Gene Sequencing

Forms and Documents

Info Sheet Test Requisition Form

Test Details

  • Confirmation of biochemical diagnosis
  • Carrier testing
  • Prenatal diagnosis in at risk pregnancies
  • Capillary Sequencing

Ordering

334
4-5 weeks
2-5 mL Blood - Lavender Top Tube
Dried Blood Spots | Buccal Swabs

Billing

81404x1
No
Yes
  • 277.85 Disorders of fatty acid oxidation, Carnitine palmitoyltransferase deficiencies, Glutaric aciduria type II, Long chain 3-hydroxyacyl CoA dehydrogenase deficiency (LCHAD), Long chain/very long chain acyl CoA dehydrogenase deficiency, Medium chain acyl CoA dehydrogenase deficiency (MCAD), Short chain acyl CoA dehydrogenase deficiency (SCAD)
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Thuillier L. et al, (2003) Hum Mutat 21:493-501.
  2. Bonnefont, J. et al, (2004) Mol Aspects Med 25 :495-520.
  3. Wieser, T. (2006) Carnitine Palmitoyltransferase II Deficiency.
  4. Isackson, P. et al, (2006) Mol Genet Metab 89:323-31.
  5. Vladutiu, G. et al, (2000) Mol Genet Metab 70:134-41.
  6. Orngreen, M. et al, (2005) Ann Neurol 57:60-6.
  7. Martin, M. et al, (2000) Hum Mutat 15:579-80.
  8. Taggart, et al, (1999) Hum Mutat 13 :210-20.
  9. Wieser, et al, (2007) Neurology 60 :1351-1353.
  10. Musumeci, O. et al, (2007) Neuromuscul Disord Jul 23 [Epub].
CREBBP Sequencing & Del/Dup

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Confirmation of a clinical diagnosis
  • Differentiation between familial and de novo cases
  • Capillary Sequencing
  • Deletion/Duplication Analysis

Ordering

2923
3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81406x1, 81407x1
No
Yes
  • 759.89 Other Congenital malformation syndromes affecting multiple systems
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Kalkhoven E et Al., (2003) Hum Mol Genet 12:441-450.
  2. Roelfsema JH et Al., (2005) Am J Hum Genet 76:572-580.
  3. Bentivegna A et Al., (2006) BMC Med Genet 7:77.
  4. Schorry EK et Al., (2008) Am J Med Genet 146A: 2512-2519.
  5. Gervasini C et Al., (2010) Eur J Hum Genet 18: 768-775.
  6. Sharma N et Al, (2010) J Biosci 35(2): 187-202.
  7. Thienpont B et Al., (2010) J Med Genet 47: 155-161.
DHCR7 Gene Sequencing

Forms and Documents

Test Info Sheet Test Requisition Form

Test Details

  • Confirmation of a suspected clinical diagnosis
  • Carrier testing in siblings or other relatives
  • Capillary Sequencing

Ordering

2502
4-5 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81405x1
No
Yes
  • 759.89 Other Congenital malformation syndromes affecting multiple systems
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Witsch-Baumgartner et al., (2000) Am J Hum Genet 66:402-412
  2. Correa-Cerro et al., (2005) Mol Gen Metab 84:112-26
  3. Yu, H. and Patel, S.B., (2005) Clin Genet 68:383-91
GALC Gene Sequencing & Del/Dup

Forms and Documents

Test Requisition Test Info Sheet

Test Details

  • Confirmation of biochemical diagnosis
  • Carrier testing
  • Prenatal diagnosis in at risk pregnancies
  • Capillary Sequencing
  • Deletion/Duplication Analysis

Ordering

507
4-5 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81406x1, 81479x1
No
Yes
  • 330.0 Leukodystrophy
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Wenger, D. (Updated [Aug. 5, 2008]) Krabbe Disease. In: GeneReviews at Genetests: Medical Genetics Information Resource (database online). Copyright, University of Washington, Seattle 1997-2010. Available at http://www.genetests.org.
  2. Lee et al., (2010) J Neurosci 30:5489-5497.
  3. Xu et al., (2006) J Hum Genet 51:548-554.
  4. Fu, et al., (1999) J Inher Metab Dis 22:155-162.
  5. Lissens et al., (2007) Hum Mutat 28:742.
  6. De Gasperi et al., (1996) Am J Hum Genet 59:1233-1242.
GCDH Gene Sequencing

Forms and Documents

Test Info Sheet Test Requisition Form

Test Details

  • Diagnostic confirmation
  • Carrier testing
  • Prenatal diagnosis in at risk pregnancies
  • Capillary Sequencing

Ordering

399
4-5 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81406x1
No
Yes
  • 276.2 Acidosis Acidosis
  • 277.8 Other specified disorders of metabolism
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Superti-Furga, A. and Hoffman, G (1997) Eur J Ped 156:821-828.
  2. Christensen E. et al., (2004) J Inherit Metab Dis 27:861-868.
  3. Hoffmann, G.F. et al., (1999) J Inher Metab Dis 22 :381-391.
  4. Zschocke, J. et al., (2000) J Med Genet 37:177- 181.
  5. Busquets, C. et al., (2000) Hum Mut 15(2):207.
  6. Goodman, SI et al., (1998) Hum Mut 12:141-4.
GCH1 Gene Sequencing & Del/Dup

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Confirmation of a clinical diagnosis
  • Selection of appropriate treatment
  • Identification of at-risk family members
  • Capillary Sequencing
  • Deletion/Duplication Analysis

Ordering

527
3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81405x1, 81479x1
No
Yes
  • 270.1 Phenylketonuria [PKU], Hyperphenylalaninemia
  • 781 Symptoms involving nervous and musculoskeletal systems Excludes: depression NOS (311) disorders specifically relating to: back (724.0-724.9) hearing (388.0-389.9) joint (718.0-719.9) limb (729.0-729.9) neck (723.0-723.9) vision (368.0-369.9) pain in limb (729.5)
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Muller Y et Al., (1998) Neurogenetics 1:165-177.
  2. Ichinose H et Al., (1994) Nat Genet 8:236-242.
  3. Bandmann O et Al., (1996) Hum Molec Genet 5:403-406.
  4. Furukawa Y et Al., (1998) Ann Neurol 44: 10-16.
  5. Furukawa Y et Al., (1998) Neurology 50:1015-20.
  6. Muller U et Al., (2002) J Neural Transm 109:321-328
  7. Furukawa Y, (2004) Adv Neurol 94:127-138.
  8. Hagenah et Al., (2005) Neurology 64:908-911.
  9. Thony B and Blau N, (2006) Hum Mutat 27:870- 878.
  10. Zirn B et Al., (2008) J Neurol Neurosurg Psych 79:183-186.
  11. Clot F et Al., (2009) Brain 132: 1753-1763.
  12. Furukawa Y, (2009) Gene Reviews GTPCH1-Deficient DRD.
GFAP Gene Sequencing

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Confirmation of a clinical diagnosis
  • Differentiation of Alexander disease from Canavan disease
  • Prenatal diagnosis in at-risk pregnancies
  • Capillary Sequencing

Ordering

218
3 weeks
2-5 mL Blood - Lavender Top Tube
Dried Blood Spots | Buccal Swabs

Billing

81405x1
No
Yes
  • 330 Cerebral degenerations usually manifest in childhood Use additional code to identify associated mental retardation
  • 742.4 Other specified anomalies of brain, Congenital cerebral cyst, Macroencephaly, Macrogyria, Megalencephaly, Multiple anomalies of brain NOS, Porencephaly Ulegyria
  • 330.8 Other specified cerebral degenerations in childhood, Alpers' disease or gray-matter degeneration, Infantile necrotizing encephalomyelopathy, Leigh's disease, Subacute necrotizing, encephalopathy or encephalomyelopathy
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Schuelke, M et al., Mutant NDUFV1 subunit of mitochondrial complex I causes leukodystrophy and myoclonic epilepsy. Nat Genet 21(3):260-1. 1999
  2. Brenner, M et al., Mutations in GFAP, encoding glial fibrillary acidic protein, are associated with Alexander disease Nature Genetics 27:117-120 (2001)
  3. Meins M et al., Infantile Alexander Disease: A GFAP Mutation in Monozygotic Twins and Novel Mutations in Two Other Patients Neuropediatrics 33:194-198 (2002)
  4. Rodriguez D et al., Infantile Alexander Disease: Spectrum of GFAP Mutations and Genotype-Phenotype Correlation Am J Hum Genet 69:1134-1140 (2001)
  5. Gorospe JR et al., Molecular findings in symptomatic and pre-symptomatic Alexander disease patients Neurology 58: 1494-1500 (2002)
GLA Gene Sequencing

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Confirmation of a clinical diagnosis
  • Mutation detection in female relatives of an affected male
  • Prenatal diagnosis in at-risk pregnancies
  • Capillary Sequencing

Ordering

2321
4-5 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81405x1
Yes
Yes
  • 272.7 Lipidoses (Fabry Disease)
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. MacDermot KD et al., J Med Genet 38:769-775 (2001)
  2. Barranger, JA & O’Rourke, E 10(1):9-15 (2002)
  3. Bennett RL et al., J of Genetic Counseling, 11(2):121-146 (2002)
  4. Schafer et al., Hum Mutat 25(4):412 (2005)
  5. Gupta et al., Medicine 84(5):261-268 (2005)
GPC3 Gene Sequencing & Del/Dup

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Confirmation of a clinical diagnosis
  • Carrier testing in individuals with a known familial GPC3 mutation
  • Prenatal diagnosis in at-risk pregnancies
  • Capillary Sequencing
  • Deletion/Duplication Analysis

Ordering

415E
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81479x1
No
Yes
  • 750.15 Macroglossia Congenital hypertrophy of tongue
  • 775.6 Neonatal hypoglycemia
  • 766.1 Other "heavy-for-dates" infants, Other fetus or infant "heavy-" or "large-for-dates" regardless of period of gestation
  • 759.89 Other Congenital malformation syndromes affecting multiple systems
  • 319 Unspecified mental retardation, Mental deficiency NOS, Mental subnormality NOS
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Lin, et al., (1999) Am. J. Hum. Genet. 83:378-381
  2. Lindsay, et al., (1997) J. Med. Genet. 34:480-483
  3. Hughes-Benzie, et al., (1996) Am. J. Hum. Genet. 66:227-234
  4. Sakazume, et al., (2007) Am. J. Med. Genet. 143A: 1703-1707
  5. Li, et al., (2001) Am. J. Hum. Genet. 102:161-168
  6. Veugelers, et al., (2000) Hum. Mol. Genet. 9:1321-1328
  7. Pilia et al., (1996) Nat Genet 12:241-247
  8. Rodriguez-Criado et al., (2005) Am J Med Genet A 138A:272-277
  9. Lapunzina (2005) Am J Med Genet C 137C:53-71
  10. Neri, et al., (1998) Am. J. Hum. Genet. 79:279-283
Septo-Optic Dysplasia (HESX1)

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Confirmation of a clinical diagnosis
  • Development of an appropriate management plan
  • Prenatal diagnosis in families with a defined mutation
  • Capillary Sequencing
  • Deletion/Duplication Analysis

Ordering

TA94
3 weeks
2-5 mL Blood - Lavender Top Tube
Dried Blood Spots | Buccal Swabs

Billing

81479x1
No
Yes
  • 377.43 Optic nerve hypoplasia
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Thomas et al., (2001) Hum Molec Genet 10: 39-45
  2. Tajima et al., (2003) J Clin Endocr Metab 88: 45-50
  3. Sobrier et al., (2006) J Clin Endocr Metab 91:4528-4536
  4. McNay et al., (2007) J Clin Endocr Metab 92:691-697
  5. Dattani et al., (1998) Nat Genet 19:125-133
HEXA Gene Sequencing

Forms and Documents

Test Info Sheet Test Requisition Form

Test Details

  • Confirmation of biochemical diagnosis especially in those with borderline enzyme activity
  • Full sequence analysis for non-Jewish partners of individuals who are known to be a mutation carrier
  • Carrier testing
  • Prenatal diagnosis in at risk pregnancies
  • Capillary Sequencing

Ordering

519
4-5 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81406x1
No
Yes
  • 330.1 Tay-Sachs disease hexosaminidase A deficiency; Cerebral lipidoses
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Kaback, M. (Updated [May 19, 2006]) Hexosaminidase A Deficiency In: GeneReviews at Genetests: Medical Genetics Information Resource (database online). Copyright, University of Washington, Seattle. 1997- 2007. Available at http://www.genetests.org.
  2. Maegawa et al., (2006) Pediatrics 118:e1550-e1562.
  3. Giraud et al., (2010) Biochem Biophys Res Commun 392:599-602.
  4. Montalvo et al., (2005) Hum Mutat 26:282.
  5. Park et al., (2010) Pediatr Res 67:217-20.
  6. Myerowitz, R. And Hogikyan, N. (1986) Science 232:1646-1648.
  7. Hechtman et al., (1992) Hum Genet 90:402-406.
  8. Triggs-Raine et al., (1990) N Engl J Med 323:6-12.
  9. Akerman et al., (1992) Hum Mutat 1:303-309.
  10. Cao et al., (1997) J Biol Chem 272:14975- 14982.
  11. Braekeleer et al., (1992) Hum Genet 89:83-87.
Holoprosencephaly Panel & Del/Dup

Forms and Documents

Test Info Sheet Test Requisition

Test Details

SHH, SIX3, TGIF, ZIC2
  • Confirmation of clinical diagnosis
  • Identification of the specific gene defect(s) to allow: (a) Identification of non-expressing mutation carriers in families with an affected member (b) Prenatal diagnosis for the specific mutation in the family
  • MLPA
  • Next-Gen Sequencing

Ordering

2371
3-4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81479x1
Yes
Yes
  • 742.2 Reduction deformities of brain Absence of part of brain, Agenesis of part of brain, Agyria Aplasia of part of brain, Arhinencephaly, Holoprosencephaly, Hypoplasia of part of brain Microgyria
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Wallis et al., (2000) Human Mutat 16:99-108
  2. Dubourg et al., (2004) Hum Mutat 24: 43-51
  3. Bendavid et al., (2005) Hum Genet 119: 1-8
  4. Bendavid et al., (2006) J Med Genet 43: 496-500
  5. Dubourg et al., (2007) Orphan J Rare Dis 2:8
  6. El-Jaik et al., (2007) Mol Genet Metab 90:97-111
  7. Bendavid et al., (2009) Hum Mutat 30: 1175-1182
  8. Lacbawan et al., (2009) J Med Genet 46:389-98
  9. Roessler et al., (2009) Hum Mutat 10:921- 993
  10. Solomon et al., (2009) J Med Genet 47:513-24
  11. Muenke, M. and Gropman, A. Holoprosencephaly Overview, www.genereviews.org. (2010)
  12. Muenke et al., (2010) Am J Med Genet 154C: 52-61
  13. Paulussen et al., (2010) Eur J Hum Genet 18: 999-1005.
  14. Solomon et al., (2010) Am J Med Genet 154C: 133-141
IDUA Gene Sequencing

Forms and Documents

Test Requisition Test Info Sheet

Test Details

IDUA
  • Molecular confirmation of a clinical diagnosis.
  • Testing of patients suspected of having Mucopolysaccharidosis Type I.
  • Prenatal diagnosis for known familial mutation(s) in at-risk pregnancies.
  • Capillary Sequencing

Ordering

T386
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81406x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Scott et al. (2013) The Journal Of Pediatrics 163 (2):498-503 (PMID: 23465405)
  2. Clarke LA. Mucopolysaccharidosis Type I. 2002 Oct 31 [Updated 2016 Feb 11]. In: Adam MP, Ardinger HH, Pagon RA, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2017. Available from: https://www.ncbi.nlm.n
  3. Stenson et al. (2014) Human genetics 133 (1):1-9 (PMID: 24077912)
  4. Breen et al. (2016) Hum Genome Var 3 :16031 (PMID: 27766162)
  5. Terlato et al. (2003) Genet. Med. 5 (4):286-94 (PMID: 12865757)
  6. Bertola et al. (2011) Hum. Mutat. 32 (6):E2189-210 (PMID: 21394825)
  7. Beesley et al. (2001) Hum. Genet. 109 (5):503-11 (PMID: 11735025)
IKBKG (NEMO) Gene Sequencing & Common Del/Dup

Forms and Documents

Test Info Sheet Test Requisition

Test Details

IKBKG (NEMO)
  • Confirmation of a clinical diagnosis
  • Carrier detection in female relatives
  • Differentiation between forms of the hypohidrotic ectodermal dysplasia
  • Prenatal diagnosis in at-risk pregnancies
  • Capillary Sequencing
  • Long Range PCR

Ordering

553
4 weeks
2-5 mL Blood - Lavender Top Tube

Billing

81479x1
No
Yes
  • 757.33 Congenital pigmentary anomalies of skin, Congenital poikiloderma, Urticaria pigmentosa, Xeroderma pigmentosum
  • 520 Disorders of tooth development and eruption
  • 361 Retinal detachments and defects
  • 757.4 Specified anomalies of hair; Congenital: alopecia atrichosis, beaded hair hypertrichosis, monilethrix, Persistent lanugo
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Aradhya S et. al (2001) Hum Molec Genet 10:2171-2179
  2. Aradhya S et al (2001) Am J Hum Genet 10:2257-2267
  3. Doffinger R et al (2001) Nat Genet 27:277-285
  4. Fusco F et al (2008). Hum Mut 29:595-604
  5. Smahi A et al (2000) Nature 405:466-472
  6. Zonana J et al (2000) Am J Hum Genet 67:1555-1562
  7. Kashtan C (1999) Medicine (Baltimore) 78:338-360
  8. Scheuerle A & Nelson DL. Incontinentia pigmenti (Bloch-Sulzberger syndrome), In: GeneReviews at GeneTests (http://www.genetests.org), accessed 07-2010
  9. Wright J et al. Hypohydrotic ectodermal dysplasia, In: GeneReviews at GeneTests, accessed 07-2010
Kabuki Syndrome Panel

Forms and Documents

Test Info Sheet Test Requisition

Test Details

KDM6A, KMT2D
  • Molecular confirmation of clinical diagnosis
  • Development of appropriate evaluation and management plan
  • Testing of at-risk relatives for specific known variant(s) previously identified in an affected family member
  • Prenatal diagnosis for known familial pathogenic variant(s) in at-risk pregnancies
  • Genetic counseling and recurrence risk assessmemt
  • Deletion/Duplication Analysis
  • Next-Gen Sequencing

Ordering

TB04
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs | Extracted DNA

Billing

81479x1
No
Yes
  • 759.7 Multiple congenital anomalies, so described Congenital: anomaly, multiple NOS deformity, multiple NOS
  • 783.43 Short stature, Growth failure, Growth retardation, Lack of growth, Physical retardation
  • 315.9 Unspecified delay in development, Developmental disorder NOS, Learning disorder NOS
  • 319 Unspecified mental retardation, Mental deficiency NOS, Mental subnormality NOS
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Wessels et al., (2002) Clinical Dysmorphol 11(2):95–102.
  2. Paulussen et al., (2010) Hum Mutat 32:E2018-E2025.
  3. Ng et al., (2010) Nat Genet 42(9):790-793.
  4. Li et al., (2011) Hum Genet 130(6):715-724.
  5. Lederer et al., (2012) Am J Hum Genet 90:119-124.
  6. Hannibal et al., (2011) Am J Med Genet A 155(7): 1511-1516.
L1CAM Gene Sequencing & Del/Dup

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Patients with hydrocephalus and at least one L1CAM–associated finding
  • Carrier testing in female relatives
  • Risk assessment
  • Prenatal diagnosis in at-risk pregnancies
  • Capillary Sequencing
  • Deletion/Duplication Analysis

Ordering

552
3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81407x1, 81479x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Vos, J. (2010) J Med Genet. 47(3):169-75
  2. Jackson, SR. (2009) Pediatr Surg Int. 25(9):823-5
  3. Jouet, M. (1994) Nature Genet. 7: 402-407, 1994
  4. Finckh, U. (2000) Am. J. Med. Genet. 92: 40-46
MCOLN1 Gene Sequencing

Forms and Documents

Test Requisition Form Test Info Sheet

Test Details

  • Confirmation of a clinical diagnosis
  • Carrier testing in unaffected family members
  • Prenatal diagnosis
  • Capillary Sequencing

Ordering

2432
4-5 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81290x1, 81479x1
Yes
Yes
  • 272.7 Lipidoses (Fabry Disease)
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Bargal (2000) Nat Genet 26, 118
  2. Sun (2000) Hum Mol Genet 9, 2471
  3. Bassi (2000) Am J Hum Genet 67, 1110
  4. Bach (2005) Hum Mutat 26(6):591
  5. Dobrovolny (2007) Am J Ophthalmol 143:663-671
  6. Bargal (2001) Hum Mutat 17:397-402
  7. Slaugenhaupt (2002) Curr Molec Med 2:445-450
MECP2 Gene Sequencing & Del/Dup

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Confirmation of clinical diagnosis
  • Differentiation between de novo and familial cases
  • Prenatal diagnosis in at-risk pregnancies
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

549
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81302x1, 81304x1
No
Yes
  • 315.3 Developmental speech or language disorder
  • 299 Pervasive developmental disorders
  • 299 Pervasive developmental disorders
  • 315.9 Unspecified delay in development, Developmental disorder NOS, Learning disorder NOS
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Zeev et al. J Child Neurol 17:20-24, 2002
  2. del Gaudio et al. Gene Med 8:784-792, 2006
  3. Van Esch H. et al. Am J Hum Genet 77,:442-453, 2005
  4. Neul et al. Neurology 70:1313-1321, 2008
  5. Bebbington et al. Neurology 70:868-875, 2008
  6. Debona et al. Eur J Hum Genet 8:325-330, 2000
  7. Hitchins et al. Am J Med Genet A 125:167-172, 2004
  8. Couvert et al. Hum Mol Genet 10:941-946, 2001
  9. Kleefstra et al. Eur J Hum Genet 12:24-28, 2004
  10. Abdul-Rahman et al. Genet Med 8:50-54, 2006
  11. Carney et al. Pediatr Neurol 28:205-211, 2003
  12. Villard. J Med Genet 44:417-423, 2007, Bunyan et al. Genet Test 12:373-376, 2008
MMACHC Gene Sequencing

Forms and Documents

Test Info Sheet Test Requisition Form

Test Details

  • Confirmation of a biochemical/clinical diagnosis
  • Carrier testing
  • Prenatal diagnosis in at risk pregnancies
  • Capillary Sequencing

Ordering

274
3-4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81404x1
No
Yes
  • 270.4 Disturbances of sulphur-bearing amino-acid metabolism, Cystathioninemia, Cystathioninuria, Disturbances of metabolism of methionine, homocystine, and cystathionine Homocystinuria, Hypermethioninemia, Methioninemia
  • 270.9 Unspecified disorder of amino-acid metabolism
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Rosenblatt, DS and Fenton, WA (2001) Inherited disorders of folate and cobalamin transport and metabolism . In: C.R. Scriver, A.L. Beaudet, W.S. Sly and D. Valle (Eds)The Metabolic and Molecular Basis of Inherited Diseases, McGraw-Hill, NY
  2. Lerner-Ellis et al. (2006) Nat. Genet. 38 (1):93-100 (PMID: 16311595)
  3. Wang et al. (2018) Metab Brain Dis : (PMID: 29374341)
  4. Lerner-Ellis et al. (2009) Hum. Mutat. 30 (7):1072-81 (PMID: 19370762)
  5. Stenson et al. (2014) Human Genetics 133 (1):1-9 (PMID: 24077912)
  6. Carrillo N, Adams D, Venditti CP. Disorders of Intracellular Cobalamin Metabolism. 2008 Feb 25 [Updated 2013 Nov 21]. In: Adam MP, Ardinger HH, Pagon RA, et al., editors. GeneReviews [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2018.
  7. Stucki et al. (2012) Human Molecular Genetics 21 (6):1410-8 (PMID: 22156578)
  8. Rutsch et al. (2011) J. Inherit. Metab. Dis. 34 (1):121-6 (PMID: 20446115)
  9. Coelho et al. (2012) Nature Genetics 44 (10):1152-5 (PMID: 22922874)
NF1 Panel

Forms and Documents

Test Info Sheet Test Requisition

Test Details

NF1, SPRED1
  • Establish or confirm a clinical diagnosis
  • Identification of at-risk family members
  • Development of an appropriate evaluation and management Prenatal diagnosis for known familial mutation(s) in at-risk pregnancies
  • Deletion/Duplication Analysis
  • MLPA
  • Next-Gen Sequencing

Ordering

962
3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81405x1, 81408x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Friedman JM. Neurofibromatosis 1. 1998 Oct 2 [Updated 2014 Sep 4]. In: Pagon RA, Adam MP, Bird TD, et al., editors. GeneReviews™ [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2013. Available from: http://www.ncbi.nlm.nih.gov/books/NBK1
  2. Evans DG. Neurofibromatosis 2. 1998 Oct 14 [Updated 2011 Aug 18]. In: Pagon RA, Adam MP, Bird TD, et al., editors. GeneReviews™ [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2013. Available from: http://www.ncbi.nlm.nih.gov/books/NBK12
  3. Stevenson D, Viskochil D, Mao R, et al. Legius Syndrome. 2010 Oct 14 [Updated 2015 Jan 15]. In: Pagon RA, Adam MP, Bird TD, et al., editors. GeneReviews™ [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2013. Available from: http://www.nc
  4. Trovo-Marqui, A, Tajara E. (2006) Clin. Genet. 70: 1-13 (PMID: 16813595)
  5. Curto M, McClatchey A. (2008) Brit. J. Cancer 98: 256-262 (PMID: 17971776)
  6. Brems et al., (2012) Hum. Mutat. 33: 1538-1546 (PMID: 22753041)
  7. Online Mendelian Inheritance in Man, OMIM®. Johns Hopkins University, Baltimore, MD. MIM Number: 609291: 09/24/13: World Wide Web URL: http://omim.org/.
  8. Spencer et al., (2011) Am J Med Genet Part A 155:1352–1359 (PMID: 21548021)
  9. Evans D. (2009) Genet Med 11: 599–610 (PMID: 19652604)
  10. Ahronowitz et al., (2007) Hum. Mutat. 28: 1-12 (PMID: 16983642)
  11. Wimmer et al., (2006) Genes Chromosomes Cancer 45:265–76 (PMID: 16283621)
  12. Valero et al. (2011) J Mol Diagn 13:113–22 (PMID: 21354044)
  13. Sabbagh et al., (2013) Hum. Mutat. 34:1510-1518 (PMID: 23913538)
  14. Baser et al., (2006) Hum Mutat. 27: 297-306 (PMID: 16521120)
  15. Stumpf et al. (1988) Arch Neurol 45:575-578 (PMID: 3128965)
  16. Messiaen et al., (2009) JAMA 302:2111–8 (PMID: 19920235)
  17. Pasmant et al., (2010) Hum Mutat 31:E1506–18 (PMID: 20513137)
  18. Online Mendelian Inheritance in Man, OMIM®. Johns Hopkins University, Baltimore, MD. MIM Number: 611413: 02/20/13: World Wide Web URL: http://omim.org/.
  19. Muram-Zborovski et al, (2010) J Chil Neurol 25(10): 1203-1209 (PMID: 20179001)
  20. Hadfield et al., (2008) J Med Genet 45:332-339 (PMID: 18285426)
  21. Plotkin et al. (2013) Am J Med Genet A 161A(3): 405-16 (PMID: 23401320)
  22. Van den Munckhof et al., (2012) Neurogenetics 13(1): 1-7 (PMID: 22038540)
  23. Bacci et al., (2010) Neurogenetics 11(1) 73-80 (PMID: 19582488)
  24. MacCollin et al., (2005) Neurology 64: 1838-1845 (PMID: 15955931)
  25. Ullrich N (2015) J of Child Neurology pii: 0883073815604220 (PMID: 26459515)
  26. MacCollin et al., (2003) Neurology 60: 1968-74 (PMID: 12821741)
  27. Slattery et al., (2015) Otolaryngol Clin North Am 48(3): 443-60 (PMID: 26043141)
  28. Smith et al., (2015) Hum Mut 37: 250-256 (PMID: 26615784)
  29. Colley et al., (1996) Clin Genet 49: 59-64 (PMID: 8740913)
NF1 Sequencing & Del/Dup

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Establish or confirm a clinical diagnosis
  • Identification of at-risk family members
  • Development of an appropriate evaluation and management
  • Prenatal diagnosis for known familial mutation(s) in at-risk pregnancies
  • MLPA
  • Next-Gen Sequencing

Ordering

J660
3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81408x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Friedman JM. Neurofibromatosis 1. 1998 Oct 2 [Updated 2014 Sep 4]. In: Pagon RA, Adam MP, Bird TD, et al., editors. GeneReviews™ [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2013. Available from: http://www.ncbi.nlm.nih.gov/books/NBK1
  2. Evans DG. Neurofibromatosis 2. 1998 Oct 14 [Updated 2011 Aug 18]. In: Pagon RA, Adam MP, Bird TD, et al., editors. GeneReviews™ [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2013. Available from: http://www.ncbi.nlm.nih.gov/books/NBK12
  3. Stevenson D, Viskochil D, Mao R, et al. Legius Syndrome. 2010 Oct 14 [Updated 2015 Jan 15]. In: Pagon RA, Adam MP, Bird TD, et al., editors. GeneReviews™ [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2013. Available from: http://www.nc
  4. Trovo-Marqui, A, Tajara E. (2006) Clin. Genet. 70: 1-13 (PMID: 16813595)
  5. Curto M, McClatchey A. (2008) Brit. J. Cancer 98: 256-262 (PMID: 17971776)
  6. Brems et al., (2012) Hum. Mutat. 33: 1538-1546 (PMID: 22753041)
  7. Online Mendelian Inheritance in Man, OMIM®. Johns Hopkins University, Baltimore, MD. MIM Number: 609291: 09/24/13: World Wide Web URL: http://omim.org/.
  8. Spencer et al., (2011) Am J Med Genet Part A 155:1352–1359 (PMID: 21548021)
  9. Evans D. (2009) Genet Med 11: 599–610 (PMID: 19652604)
  10. Ahronowitz et al., (2007) Hum. Mutat. 28: 1-12 (PMID: 16983642)
  11. Wimmer et al., (2006) Genes Chromosomes Cancer 45:265–76 (PMID: 16283621)
  12. Valero et al. (2011) J Mol Diagn 13:113–22 (PMID: 21354044)
  13. Sabbagh et al., (2013) Hum. Mutat. 34:1510-1518 (PMID: 23913538)
  14. Baser et al., (2006) Hum Mutat. 27: 297-306 (PMID: 16521120)
  15. Stumpf et al. (1988) Arch Neurol 45:575-578 (PMID: 3128965)
  16. Messiaen et al., (2009) JAMA 302:2111–8 (PMID: 19920235)
  17. Pasmant et al., (2010) Hum Mutat 31:E1506–18 (PMID: 20513137)
  18. Online Mendelian Inheritance in Man, OMIM®. Johns Hopkins University, Baltimore, MD. MIM Number: 611413: 02/20/13: World Wide Web URL: http://omim.org/.
  19. Muram-Zborovski et al, (2010) J Chil Neurol 25(10): 1203-1209 (PMID: 20179001)
  20. Hadfield et al., (2008) J Med Genet 45:332-339 (PMID: 18285426)
  21. Plotkin et al. (2013) Am J Med Genet A 161A(3): 405-16 (PMID: 23401320)
  22. Van den Munckhof et al., (2012) Neurogenetics 13(1): 1-7 (PMID: 22038540)
  23. Bacci et al., (2010) Neurogenetics 11(1) 73-80 (PMID: 19582488)
  24. MacCollin et al., (2005) Neurology 64: 1838-1845 (PMID: 15955931)
  25. Ullrich N (2015) J of Child Neurology pii: 0883073815604220 (PMID: 26459515)
  26. MacCollin et al., (2003) Neurology 60: 1968-74 (PMID: 12821741)
  27. Slattery et al., (2015) Otolaryngol Clin North Am 48(3): 443-60 (PMID: 26043141)
  28. Smith et al., (2015) Hum Mut 37: 250-256 (PMID: 26615784)
  29. Colley et al., (1996) Clin Genet 49: 59-64 (PMID: 8740913)
NPC1/NPC2 Sequencing Panel

Forms and Documents

Test Info Sheet Test Requisition Form

Test Details

NPC1, NPC2
  • Confirmation of a clinical diagnosis
  • Carrier testing in unaffected family members
  • Prenatal diagnosis in families with known mutation
  • Capillary Sequencing

Ordering

581
4-5 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81406x1, 81404x1
No
Yes
  • 330.2 Cerebral degeneration in generalized lipidoses; Code first underlying disease, as: Fabry's disease (272.7), Gaucher's disease (272.7), Niemann-Pick disease (272.7), sphingolipidosis (272.7)
  • 272.2 Mixed hyperlipidemia, Broad- or floating-betalipoproteinemia, Combined hyperlipidemia, Elevated cholesterol with elevated triglycerides NEC, Fredrickson Type IIb or III hyperlipoproteinemia, Hypercholesterolemia with endogenous hyperglyceridemia, Hyperbetalipoproteinemia with prebetalipoproteinemia, Tubo-eruptive xanthoma Xanthoma tuberosum
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Millat et al., (2005) Mol Genet Metab 86:220-232
  2. Park et al., (2003) Hum Mut 22:313
  3. Verot et al., (2007) Clin Genet 71:320-30
  4. Sevin et al., (2007) Brain 130:120-133
  5. Fernandez-Valero et al., (2005) Clin Genet 68 :245-254
NSD1 Gene Sequencing & Del/Dup

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Confirmation of a clinical diagnosis
  • Prenatal diagnosis in at-risk pregnancies
  • Capillary Sequencing
  • Deletion/Duplication Analysis

Ordering

406
4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81405x1, 81406x1
No
Yes
  • 766.1 Other "heavy-for-dates" infants, Other fetus or infant "heavy-" or "large-for-dates" regardless of period of gestation
  • 759.89 Other Congenital malformation syndromes affecting multiple systems
  • 319 Unspecified mental retardation, Mental deficiency NOS, Mental subnormality NOS
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Tatton-Brown and Rahman (2004) Clin Dysmorphol 13: 199-204
  2. Tatton-Brown et al., (2005) Am J Hum Genet 77: 193-204
  3. Lapunzina (2005) Am J Med Genet C 137C:53-71
  4. Baujat and Cormier-Daire (2007) Orph J Rare Dis 2:36
  5. Kurotaki et al., (2003) Hum Mutat 22:378-87
  6. Visser et al., (2005) J Med Genet 42e
  7. Waggoner et al., (2005) Genet Med 7: 524-33
  8. Saugier-Veber et al., (2007) Hum Mutat 28(11):1098-1107
  9. Douglas et al., (2005) J Med Genet 42:e56
  10. Rio et al., (2003) J Med Genet 40:436-440
  11. Cecconi et al., (2005) Am J Med Genet 134A:247-253
  12. Turkmen et al., (2003) Am J Med Genet 137C:24-31
Congenital Insensitivity to Pain and Anhidrosis (NTRK1)

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Confirmation of the clinical diagnosis
  • Carrier testing in unaffected family members
  • Prenatal diagnosis in families with an affected child and known mutation(s)
  • Capillary Sequencing
  • Deletion/Duplication Analysis

Ordering

TA60
3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81479x1
No
Yes
  • 705 Disorders of sweat glands
  • 778.4 Other disturbances of temperature regulation of newborn, Dehydration fever in newborn, Environmentally induced pyrexia, Hyperthermia in newborn, Transitory fever of newborn
  • 742.8 Other specified anomalies of nervous system, Agenesis of nerve, Displacement of brachial plexus, Familial dysautonomia, Jaw-winking syndrome, Marcus-Gunn syndrome, Riley-Day syndrome
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Wieczorek S, et al. Neuromuscul Disord. 2008; 18:681-4
  2. Rotthier A, et al. Brain. 2009; 132:2699-711
  3. Indo Y, et al. Hum Mutat. 2001; 18:462-71
  4. Houlden H, et al. Neurol. 2001; 49:521-5
  5. Kilic S, et al. Neurogenetics. 2009; 10:161-5
OTC Gene Sequencing (Males)

Forms and Documents

Test Info Sheet Test Requisition Form

Test Details

  • Confirmation of biochemical diagnosis
  • Identification of males with partial enzyme deficiency
  • Prenatal diagnosis in at risk pregnancies
  • Capillary Sequencing

Ordering

313
4-5 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81405x1
No
Yes
  • 270.6 Disorders of urea cycle metabolism, Argininosuccinic aciduria, Citrullinemia, Disorders of metabolism of ornithine, citrulline, argininosuccinic acid, arginine, and ammonia, Hyperammonemia, Hyperornithinemia
  • 277.8 Other specified disorders of metabolism
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Ogino et al., (2007) Kobe J Med Sci 53:229-240
  2. Luksan et al., (2010) Hum Mutat 31:E1294-303
  3. Tuchman, M., et al., (1998) Mol Genet Metab 21:40S- 58S
  4. Bowlig et al., (1999) Am J Med Genet 85:452
  5. Yamaguchi, S., et al, (2006) Hum Mutat 27(7):626-632
  6. Tuchman, M., et al, (2002) Hum Mutat 19 :93-107
OTC Gene Sequencing & Del/Dup (Females)

Forms and Documents

Test Info Sheet Test Requisition Form

Test Details

  • Confirmation of biochemical diagnosis
  • Identification of females heterozygous for a mutation
  • Prenatal diagnosis in at risk pregnancies
  • Capillary Sequencing
  • Deletion/Duplication Analysis

Ordering

313E
4-5 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81405x1, 81479x1
No
Yes
  • 270.6 Disorders of urea cycle metabolism, Argininosuccinic aciduria, Citrullinemia, Disorders of metabolism of ornithine, citrulline, argininosuccinic acid, arginine, and ammonia, Hyperammonemia, Hyperornithinemia
  • 277.8 Other specified disorders of metabolism
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Yamaguchi, S., et al, (2006) Hum Mutat 27(7):626-632
  2. Tuchman, M., et al, (2002) Hum Mutat 19 :93-107
  3. Bowlig et al., (1999) Am J Med Genet 85:452
  4. Luksan et al., (2010) Hum Mutat 31:E1294-303
  5. Ogino et al., (2007) Kobe J Med Sci 53:229-240
  6. Tuchman, M., et al., (1998) Mol Genet Metab 21:40S- 58S
Prader-Willi Syndrome Methylation Analysis

Forms and Documents

Test Requisition Test Info Sheet

Test Details

  • Confirmation of clinical diagnosis
  • Targeted testing for a known familial deletion, UPD or imprinting error
  • Prenatal diagnosis by targeted array CGH for deletions or UPD only (methylation analysis not available for prenatal).
  • MLPA

Ordering

595
3-4 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81331x1
Yes
Yes
  • 315.3 Developmental speech or language disorder
  • 759.8 Other specified anomalies
  • 315.9 Unspecified delay in development, Developmental disorder NOS, Learning disorder NOS
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Jin, D.K. et al. (2011) Korean J Pediatr, 54(2):55-63.
  2. Whittington, J. et al. (2010) Am J Med Genet, 154C:438-447.
  3. Dykens, E. & Shah, B. (2003) CNS Drugs, 17(3):167-178.
  4. Milner, K. et al. (2005) J Child Psychol Psyc, 46(10):1089-1096.
  5. Chai, J-H. et al. (2003) Am J Hum Genet, 73:898-925.
  6. Veltman, M. et al. (2005) Psych Genet, 15:243-254.
  7. Bittel, D.C. et al. (2006) Pediatrics, 118(4):e1276-1283.
  8. Buiting, K. et al. (2003) Am J Hum Genet, 72:571-577.
  9. Holm, V. et al. (1993) Pediatrics, 91:398-402.
  10. Gunay-Aygun, M. et al. (2001) Pediatrics, 108(5):e92.
  11. Cassidy, S. and Schwartz, S. (Updated September 3, 2009). Prader-Willi Syndrome. In: GeneReviews at GeneTests: Medical Genetics Information Resource (database online). Copyright, University of Washington, Seattle. 1993-. Available at http://www.genetests.
PTCH1 Gene Sequencing & Del/Dup

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • An individual presenting with numerous basal cell carcinomas (BCCs) (>5 in a lifetime) or a BCC before age 30 years.
  • An individual with fewer than 5 BCC but with other suggestive features of nevoid basal cell carcinoma syndrome (NBCCS) may also be appropriate for testing (see features below).
  • An individual presenting with one or more associated features of NBCCS, such as lamellar calcification of the falx before age 20 years, multiple palmar pits, jaw keratocyst, childhood medulloblastoma, ovarian and/or cardiac fibroma, vertebral/rib anomalies (e.g. bifid/splayed/extra ribs; bifid vertebrae), macrocephaly, among others.
  • An unaffected individual with a family history suggestive of NBCCS when the affected individual is unavailable for his or her own genetic testing.
  • Capillary Sequencing
  • Deletion/Duplication Analysis

Ordering

205
3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs | Fibroblasts (separate charge for cell culture may apply)

Billing

81479x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Klein, R. et al., Clinical testing for the nevoid basal cell carcinoma syndrome in a DNA diagnostic laboratory. Genet Med. 7: 611-19, 2005
  2. Wicking, C. et al., Most Germ-Line Mutations in the Nevoid Basal Cell Carcinoma Syndrome Lead to a Premature Termination of the PATCHED Protein, and No Genotype-Phenotype Correlations Are Evident. Am J Hum Genet. 60: 21-26, 1997
  3. Lindström, E. et al., PTCH Mutations: Distribution and Analyses. Hum Mutat. 27: 215-19, 2006
  4. Benhamed S and Bale S. Gorlin Syndrome: A substantial proportion of previously “missing” mutations are large PTCH deletions. ASHG Abstract presented 2008.
PTEN Gene Sequencing and Del/Dup

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • An adult with features of PTEN hamartoma tumor syndrome (PHTS), such as characteristic skin lesions (trichilemmomas, acral keratoses, papillomas, lipomas, etc.), macrocephaly, gastrointestinal polyps (especially hamartomas or ganglioneuromas), Lhermitte-Duclos disease, or associated cancers (breast, endometrial, non-medullary thyroid, renal, melanoma, colon), among other features
  • A child with early-onset features of PHTS, such as macrocephaly, autism, developmental delay, lipomas, penile freckling, or vascular anomalies, among other features
  • An unaffected individual with a family history suggestive of PHTS (see above) when an affected individual is unavailable for his or her own genetic testing
  • Capillary Sequencing
  • Deletion/Duplication Analysis

Ordering

195
3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs | Fibroblasts (separate charge for cell culture may apply)

Billing

81321x1, 81323x1
Yes
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Eng, C. Hum Mutat. 22: 183-98, 2003
  2. Marsh, D.J. et al. Hum Mol Genet. 7: 507-15, 1998
  3. Zhou, X.P. et al. Am J Hum Genet. 73: 404-11, 2003
  4. Pezzolesi, M. et al. Hum Mol Genet. 16: 1058-71, 2007
  5. Zhou, X.P. et al. Hum Mol Genet. 9: 765-8, 2000
  6. Zhou, X.P. et al. Lancet. 358: 210-1, 2001
  7. Barker, K. et al. J Med Genet. 38: 480-1, 2001
  8. Smith, J.M. et al., J Med Genet. 39: 937-40, 2002
RAI1 Gene Sequencing & Del/Dup

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Confirmation of clinical diagnosis
  • Recurrence risk estimation
  • Capillary Sequencing
  • Deletion/Duplication Analysis

Ordering

2511
3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81405x1, 81479x1
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Nakamine, A. et al., Duplication of 17(p11.2p11.2) in a male child with autism and severe language delay. Am J Med Genet. 146A(5):636-643, 2008
  2. Dr. Sarah Elsea, personal communication, 2005
  3. Girirajan, S. et al., RAI1 variations in Smith-Magenis syndrome patients without 17p11.2 deletions. J Med Genet. 42: 820-28, 2005
  4. Bi, W. et al., Mutations of RAI1, a PHD-containing protein, in non-deletion patients with Smith-Magenis syndrome. Hum Genet. 115: 515-24, 2004
  5. Slager, R.et al., Mutations in RAI1 associated with Smith-Magenis syndrome. Nat Genet. 33: 466-68 2003
  6. Girirajan, S. et al., Genotype-phenotype correlation in Smith-Magenis syndrome: Evidence that multiple genes in 17p11.2 contribute to the clinical spectrum. Genet Med. 8: 417-27, 2006
RSK2 (RPS6KA3) Gene Sequencing & Del/Dup

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Confirmation of the clinical diagnosis
  • Carrier testing in female relatives
  • Capillary Sequencing
  • Deletion/Duplication Analysis

Ordering

550
3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81479x1
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Delaunoy et al., (2001) Hum Mutat 17:103-116
  2. Delaunoy et al., (2006) Clin Genet 70:161-166
  3. Zeniou et al., (2002) Am J Hum Genet. 70:1421-1433
  4. Hanauer et al., (2002) J Med Genet. 39: 705-713, 2002
Erythermalgia/Paroxysmal Extreme Pain Disorder/Small Fiber Neuropathy/Congenital Insensitivity to Pain (SCN9A)

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Confirmation of a clinical diagnosis
  • To differentiate SCN9A-related pain disorders from other genetic or environmental causes of pain
  • Carrier testing for individuals with a known familial SCN9A mutation
  • Prenatal diagnosis in at-risk pregnancies
  • Capillary Sequencing
  • Deletion/Duplication Analysis

Ordering

TB12
6-7 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81479x1
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Fertleman et al., (2006) Neuron 52;767- 774.
  2. Faber et al., (2012) Ann Neurol 71 :26-39.
  3. Goldberg et al., (2007) Clin Genet 71:311-319.
  4. Dabby R., (2012) Curr Neurol Neurosci Rep 12 :76-83.
  5. Fischer, T.Z. and Waxman, S.G., (2010) Ann NY Acad Sci 1184:196-207.
  6. Dib-Hajj et al., (2008) Adv in Genet 63:85-110.
  7. Drenth et al., (2005) J Invest Dermatol 124:1233-1238.
Angelman/Angelman-Like Syndrome (SLC9A6)

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Confirmation of clinical diagnosis
  • Targeted testing for a known familial mutation
  • Prenatal diagnosis in at risk pregnancies
  • Capillary Sequencing
  • Deletion/Duplication Analysis

Ordering

TA81
5-6 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81406x1
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Boyes L., et al. Eur J Med Genet. (2006) 49(6):472-80
  2. Fichou et al. European Journal of Human Genetics (2009) 17, 1378–1380
  3. Russo, S., et al, (2000) Hum Mutan 15(4):387-393
  4. Clayton-Smith, J., et al (2003) J Med Genet 40(2):87-95
  5. Schroer R., et al. Am J Med Genet. (2009) 152A:2775-2783
  6. Malzac, P., et al, (1998) Am J Hum Genet 62(6):1353-1360
  7. Gillfillan G et al., Am. J. Hum. Genet. 82(4): 1003- 1010, 2008
  8. Christianson A et al. Am J. Hum Genet. 36:759-766, 1999
  9. Williams, C.A. Dagli, A.I.and Driscoll, D.J. (Updated September 5, 2008). Angelman Syndrome. In: GeneReviews at GeneTests: Medical Genetics Information Resource (database online). Copyright, Univeristy of Washington, Seattle. 1997-2009
  10. Hitchins, M.P., et al, (2004) Am J Med Genet 125A(2):167-172
  11. Lossie, A.C., et al, (2001) J Med Genet 38(12):834-845
  12. Fang, P., et al, (1991) Hum Molec Genet 8(1):129-135
SMPD1 Gene Sequencing

Forms and Documents

Test Info Sheet Test Requisition Form

Test Details

  • Confirmation of a clinical diagnosis
  • Carrier testing in unaffected family members
  • Prenatal diagnosis in families with known mutation(s)
  • Capillary Sequencing

Ordering

2631
4-5 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81330x1
No
Yes
  • 330.2 Cerebral degeneration in generalized lipidoses; Code first underlying disease, as: Fabry's disease (272.7), Gaucher's disease (272.7), Niemann-Pick disease (272.7), sphingolipidosis (272.7)
  • 272.2 Mixed hyperlipidemia, Broad- or floating-betalipoproteinemia, Combined hyperlipidemia, Elevated cholesterol with elevated triglycerides NEC, Fredrickson Type IIb or III hyperlipoproteinemia, Hypercholesterolemia with endogenous hyperglyceridemia, Hyperbetalipoproteinemia with prebetalipoproteinemia, Tubo-eruptive xanthoma Xanthoma tuberosum
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Simonaro CM, Park J-H, Eliyahu E, Shtraizent N, McGovern MM, Schuchman EH (2006). Am J Hum Genet 78:865-70;
  2. Sikora J, PavluPereira H, Elleder M, Roelofs H, Wevers RA (2003). Annals of Human Genetics 67:63-70
  3. Simonaro CM, Desnick RJ, McGovern MM, Wasserstein MP, Schuchman EH (2002. Am J Hum Genet 71:1413-9
  4. Fernandez-Burriel M, Pena L, Ramos JC, Cabrera JC, Marti M, Rodriguez-Quinones F, Chabas A (2003). Clin Genet 63(3):235-6
  5. McGovern MM, Schuchman EH (Updated 12-06-2006) Acid sphingomyelinase deficiency, In: GeneReviews at GeneTests: Medical Genetics Information Resource (databse online)
Tyrosine Hydroxylase Deficiency (TH)

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Confirmation of a clinical diagnosis
  • Identification of at-risk family members
  • Capillary Sequencing
  • Deletion/Duplication Analysis

Ordering

TA78
3 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81406x1
No
Yes
  • 348.3 Encephalopathy, not elsewhere classified
  • 780.6 Fever and other physiologic disturbances of temperature regulation
  • 251.2 Hypoglycemia, unspecified Hypoglycemia: NOS reactive spontaneous
  • 374.3 Ptosis of eyelid
  • 781 Symptoms involving nervous and musculoskeletal systems Excludes: depression NOS (311) disorders specifically relating to: back (724.0-724.9) hearing (388.0-389.9) joint (718.0-719.9) limb (729.0-729.9) neck (723.0-723.9) vision (368.0-369.9) pain in limb (729.5)
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. HGMD Professional 2010.3
  2. Willemsen et al., (2010) Brain 133:1810-1822
  3. Pons R et al., (2010) Mov Disord 25(8): 1086-90
  4. Zafeiriou et al., (2009) Mol Genet Metab 97:18-20
  5. Clot et al., (2009) Brain 132: 1753- 1763
  6. Swoboda (2008) TH Deficiency http://www.genetests.org
  7. Verbeek et al., (2007) Ann Neurol 62:422-426
  8. Ribases et al., (2007) Mol Genet Metab 92:274-277
  9. Schiller et al., (2004) Neurology 63:1524-1526
  10. Furukawa et al., (2001) Neurology 56:260-263
  11. Janssen et al., (2000) Ann Hum Genet 64:375-382
  12. Wevers et al., (1999) J Inher Metab Dis 22:364- 373
  13. Van den Heuvel et al., (1998) Hum Genet 102:644-6
TPP1 (CLN2) Gene Sequencing

Forms and Documents

Test Info Sheet Test Requisition Form

Test Details

TPP1 (CLN2)
  • Confirmation of biochemical diagnosis
  • Carrier testing
  • Prenatal diagnosis in at risk pregnancies
  • Capillary Sequencing

Ordering

607
4-5 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81479x1
No
Yes
  • 369 Blindness and low vision Excludes: correctable impaired vision due to refractive errors (367.0-367.9) Note: Visual impairment refers to a functional limitation of the eye (e.g., limited visual acuity or visual field). It should be distinguished from visual disability, indicating a limitation of the abilities of the individual (e.g., limited reading skills, vocational skills), and from visual handicap, indicating a limitation of personal and socioeconomic independence (e.g., limited mobility, limited employability). The levels of impairment defined in the table after 369.9 are based on the recommendations of the WHO Study Group on Prevention of Blindness (Geneva, November 6-10, 1972; WHO Technical Report Series 518), and of the International Council of Ophthalmology (1976). Note that definitions of blindness vary in different settings. For international reporting, WHO defines blindness as profound impairment. This definition can be applied to blindness of one eye (369.1, 369.6) and to blindness of the individual (369.0). For determination of benefits in the U.S.A., the definition of legal blindness as severe impairment is often used. This definition applies to blindness of the individual only.
  • 345 Epilepsy and recurrent seizures The following fifth-digit subclassification is for use with categories 345.0, .1, .4-.9: 0 without mention of intractable epilepsy 1 with intractable epilepsy pharmacoresistant (pharmacologically resistant) poorly controlled treatment resistant refractory (medically) Excludes: hippocampal sclerosis (348.81) mesial temporal sclerosis (348.81) progressive myoclonic epilepsy (333.2) temporal sclerosis (348.81)
  • 272.7 Lipidoses (Fabry Disease)
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Mole, S. and Williams, R. (Updated [March 2, 2010])Neuronal Ceroid-Lipofuscinoses. In: GeneReviews at Genetests: Medical Genetics Information Resource (database online). Copyright, University of Washington, Seattle. 1997-2011. Available at http://www.gene
  2. Hofmann et al., (2002) Curr Mol Med 2:423-437.
  3. Sleat et al., (1999) Am J Hum Genet 64:1511-1523.
  4. Zhong et al., (2000) Genet Med 2:312-318.
TTR Gene Sequencing

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Confirmation of a clinical diagnosis
  • Differentiation between cardiac amyloidosis and other cardiomypopathies
  • Carrier testing in at-risk family members
  • Prenatal diagnosis in families with a known pathogenic variant
  • Capillary Sequencing

Ordering

363
4-5 weeks
2-5 mL Blood - Lavender Top Tube
Dried Blood Spots | Buccal Swabs

Billing

81404x1
Yes
Yes
  • 277.3 Amyloidosis
  • 425.7 Nutritional and metabolic cardiomyopathy; Code first underlying disease, as: amyloidosis (277.30-277.39), beriberi (265.0), cardiac glycogenosis (271.0), mucopolysaccharidosis (277.5), thyrotoxicosis (242.0-242.9)
  • 277.39 Other amyloidosis, Hereditary cardiac amyloidosi,s Inherited systemic amyloidosis, Neuropathic (Portuguese) (Swiss) amyloidosis, Secondary amyloidosis
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
UBE3A Gene Sequencing & Del/Dup

Forms and Documents

Test Info Sheet Test Requisition

Test Details

  • Confirmation of clinical diagnosis
  • Targeted testing for a known familial mutation
  • Prenatal diagnosis in at risk pregnancies
  • Capillary Sequencing
  • ExonArray CGH

Ordering

546
6-7 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81406x1, 81479x1
No
Yes
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Boyes L., et al. Eur J Med Genet. (2006) 49(6):472-80
  2. Fichou et al. European Journal of Human Genetics (2009) 17, 1378–1380
  3. Clayton-Smith, J., et al (2003) J Med Genet 40(2):87-95
  4. Russo, S., et al, (2000) Hum Mutan 15(4):387-393
  5. Fang, P., et al, (1991) Hum Molec Genet 8(1):129-135
  6. Hitchins, M.P., et al, (2004) Am J Med Genet 125A(2):167-172
  7. Lossie, A.C., et al, (2001) J Med Genet 38(12):834-845
  8. Dagli AI, Mueller J, Williams CA. Angelman Syndrome. 1998 Sep 15 [Updated 2015 May 14]. In: Pagon RA, Adam MP, Ardinger HH, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2017.
  9. Malzac, P., et al, (1998) Am J Hum Genet 62(6):1353-1360
  10. Gillfillan G et al., Am. J. Hum. Genet. 82(4): 1003- 1010, 2008
  11. Christianson A et al. Am J. Hum Genet. 36:759-766, 1999
  12. Schroer R., et al. Am J Med Genet. (2009) 152A:2775-2783
Cohen Syndrome (VPS13B)

Forms and Documents

Test Info Sheet Test Requisition

Test Details

VPS13B (COH1)
  • Confirmation of clinical diagnosis
  • Carrier testing for family members of the affected individual
  • Prenatal diagnosis in at-risk pregnancies
  • Capillary Sequencing
  • Deletion/Duplication Analysis

Ordering

TA58
10-12 weeks
2-5 mL Blood - Lavender Top Tube
Buccal Swabs

Billing

81408x1
No
Yes
  • 759.89 Other Congenital malformation syndromes affecting multiple systems
  • 744.9 Unspecified anomalies of face and neck Congenital: anomaly NOS of face [any part] or neck [any part] deformity, NOS of face [any part] or neck [any part]
For price inquiries please email zebras@genedx.com

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

References

  1. Kolehmainen, J. et al., (2004) Am J Hum Gene. 75:122-27
  2. Kolehmainen, J. et al., (2003) Am J Hum Genet 72:1359-69
  3. Hennies, H.C. et al., (2004) Am J Hum Gene. 75:138-45
  4. Mochida, G.H. et al., (2004) J Med Genet 41:e87
  5. Balikova et al., (2009) Hum Mutat 30:E845-E854
  6. Parri et al., (2010) Eur J Hum Genet Epub:1-8

Neurology Variant Testing Program (VTP)

Laboratories classify genetic changes as variants of uncertain significance (VUS) if there is incomplete or conflicting information about the health consequences of the variant. In some cases, testing family members for the presence or absence of the VUS may contribute to a better understanding of the variant and may be one piece of evidence leading to eventual reclassification of a VUS as a pathogenic, likely pathogenic, benign, or likely benign variant. For such cases, GeneDx has established a Variant Testing Program (VTP).

How do I determine if a variant is eligible for the Neurology VTP?

GeneDx considers requests for the Neurology VTP for any individual found to have a VUS identified through Neurology genetic testing at our laboratory. Given the high rate of de novo variants in some neurological disorders, we may also offer the VTP to parents of an individual with a likely pathogenic (LPATH) variant. These studies will be performed at no additional charge for select and pre-approved family members who meet certain criteria and for whom appropriate clinical information is provided. Genetic testing for other variants or additional family members, including predictive testing, is not included in our VTP and can be ordered separately for charge. GeneDx will make the final determinations for VTP in its sole discretion.

Application process for the Neurology VTP:

  • In some cases, the ‘Recommendations’ section of the proband’s report may specify that testing for a VUS is available at no additional charge through the VTP for the biological mother and biological father of the proband. Clinical information on the parents (and proband) must be provided at the time of testing in order for targeted testing to be performed at no charge, but no additional prior approval is required for these cases.
  • If parents are not available, there may be other informative family members eligible for VTP testing. Requests to consider testing for relatives other than the biological parents, or requests for other variants not specified in the ‘Recommendations’ section of the report, should be submitted for advance review. Please fax a detailed pedigree and any relevant clinical information/evaluations to the GeneDx Neurology genetic counselors at 301-519-2892, email zebras@genedx.com, or call 301-519-2100 and ask to speak with a Neurology genetic counselor. Please be sure to indicate that you are submitting the information for VTP consideration and include the name and/or GeneDx accession number of the proband.
  • Our team will review the case and will determine if there are informative family members appropriate for evaluation through the VTP. Cases are typically reviewed within a few days, but please allow up to 3 weeks after receipt of the application for a reply.
  • A member of our team will contact the ordering provider or genetic counselor after the case has been reviewed to let him/her know if the family has been accepted in the VTP. If we are extending an offer for family member variant testing at no additional charge, we will discuss logistics of sample submission at that time.
  • Our typical policy is that we will test up to two informative family members at no charge. On a case by case basis, we may consider testing additional family members at no additional charge, depending on the disorder and the family history.

Reasons why a family might not be accepted into the Neurology VTP:

  • There are no informative family members available for testing.
  • In certain circumstances, it may be more informative to perform more comprehensive diagnostic genetic testing in affected family member(s) instead of targeted testing of one or more unaffected relatives for a VUS.
  • The VUS is in a gene for which there is no currently described phenotype (i.e. candidate or novel gene).
  • The variant is in a gene that does not correspond well with the clinical phenotype reported in the proband or the medical history in the family.
  • Segregation studies involving genes with incomplete penetrance or variable age-of-onset are challenging, especially in unaffected individuals; therefore, VTP studies are less likely to be approved for such genes.
  • Segregation studies involving genes that may cause either an autosomal dominant or an autosomal recessive disorder are also more challenging than studies involving highly penetrant autosomal dominant genes; therefore, VTP studies are less likely to be approved for such genes.
  • Variant studies for the evaluation of a single VUS in a gene associated with an autosomal recessive disorder are rarely informative. Therefore, these requests are typically denied.

Revising the classification of variants of uncertain significance takes a great deal of data and information from multiple sources. Therefore, there is no guarantee that participation in the VTP will lead to an updated classification of a VUS based on information from a single family, although cumulative data collected from multiple families over time may lead to a more definitive classification for a variant.

For more information please contact:
The GeneDx Neurology Genetic Counselors at 301-591-2100