DMD Gene Analysis Known Familial Variants

Label Mnemonic:	DBMDKNM
Epic code:	LAB5767
Downtime form:	Doctor/Provider Orders - Pathology Core and Specialty Care Nursery

Commercial Mailout Laboratory
6240-8 RCP
356-8593

Specimen(s):

Whole Blood

Specimen Instructions:

Requisition form must accompany specimen. Please have patient, or their legal guardian, sign consent form and submit it with the sample.

Label each tube with the individual's name, date of birth, sex and the date collected.

Collection Medium:

	and		and
Yellow top tube 8.5 mL (ACD solution A)	and	Yellow top tube 8.5 mL (ACD solution A)	and	Yellow top tube 8.5 mL (ACD solution A)

Minimum:

THREE 8.5 mL (Yellow top ACD tubes) for each participant

Delivery Instructions:

Submit specimen to laboratory as soon as possible after collection.

Turn Around Time:

6 weeks

Reference Range:

Not detected

Comments:

Please print, complete, and submit the Information/Billing and DNA Testing Consent Form for (DBMD from University of Utah Genome Center with the appropriate signatures, the correct sample type and the A-1a Miscellaneous Request.

This mailout test requires pathologist approval for orders during inpatient encounters. Mailouts staff will not process order without approval. The pathologist covering mailouts approval can be reached at pager #3724. If approval is given, the name of the pathologist can be selected in the drop-down menu to the right of the approval warning in Epic when ordering the test.

Methodology:

Sequencing of single exon

CPT Code:

81403