LEUKEMIA/LYMPHOMA IMMUNOPHENOTYPING BY FLOW CYTOMETRY

General Information

HLAB/HOL Code: FLOW
UPHSM LIS Test #:
Schedule: Monday - Saturday
Testing Time: 8 Hours
Testing Lab: UP Health System-Marquette

Specimen Info
Only 1 specimen type required, unless otherwise specified

Volume:
Temperature: Ambient
Tube Type: Peripheral Blood
Collection Info:
Draw 5 to 10mL of peripheral blood in a yellow-top (ACD) or purple-top (EDTA) tube. Do not transfer blood to other containers. Send a copy of a recent CBC and 2 unstained slides. Forward at room temperature only, preferrably in an ambient blood/bone marrow container (which can be requested by calling MGHS Central Processing.)
SAMPLES CANNOT BE FROZEN.
Submit a requisition clearly stating "Leukemia / Lymphoma Immunophenotyping" as well as the appropriate collection time and date of sample.
Submit the name and telephone number of the ordering physician along with a brief diagnostic history of the patient, including the clinical differential diagnosis.
Volume:
Temperature: Ambient
Tube Type: Bone Marrow
Collection Info:
Send 5 to 10mL of ACD bone marrow and 2 unstained slides(these can be the same as those intended for bone marrow morphological evaluation). Forward at room temperature only, preferrably in an ambient blood/bone marrow container (which can be requested by calling MGHS Central Processing.)
SAMPLES CANNOT BE FROZEN.
Submit a requisition clearly stating "Leukemia / Lymphoma Immunophenotyping" as well as the appropriate collection time and date of sample.  Submit the name and telephone number of the ordering physician along with a brief diagnostic history of the patient, including the clinical differential diagnosis. (Please Send a current CBC printout with each request as well.)
Volume:
Temperature: Ambient if received in lab within 8 hrs of collection. Refrigerated if specimen will be delayed to lab for more than 8 hours post collection
Tube Type: CSF
Collection Info:
The volume of fluid necessary to adequately perform immunophenotyping depends on the cellularity of the fluid. If a cell count has been done on the sample prior to shipping enclose a copy of that result. Due to the rapid degradation of cells in a sample of this type if resonably possible, send 2 unstained cytocentrifuged smears in order to properly correlate morphologic evaluation with phenotype data. If the CSF sample will not be analyzed the same day it is colleted it should be added to 15-20 mL of a Hank's balanced salt solution and transported to the lab.
SAMPLES CANNOT BE FROZEN.
Submit a requisition clearly stating "Leukemia / Lymphoma Immunophenotyping" as well as the appropriate collection time and date
of sample.  Submit the name and telephone number of the ordering physician along with a brief diagnostic history of the patient, including the clinical differential diagnosis. Please Send a current CBC printout with each request as well.
Volume:
Temperature: Ambient if received in lab within 8 hrs of collection. Refrigerated if specimen will be delayed to lab for more than 8 hours post collection
Tube Type: Body Fluids
Collection Info:
The volume of fluid necessary to adequately perform immunophenotyping depends on the cellularity of the fluid. A volume of 20mL is usually sufficient. If possible, fluids other than CSF should be transported in Hanks balanced salt solution. Due to the rapid degradation of cells in a sample  of this type, if reasonably possible send 2 unstained cytocentrifuged smears accompany the sample in order to properly correlate morphologic evaluation with phenotype data.
SAMPLES CANNOT BE FROZEN.
Submit a requisition clearly stating "Leukemia / Lymphoma Immunophenotyping" as well as the appropriate collection time and
date of sample.  Submit the name and telephone number of the ordering physician along with a brief diagnostic history of the patient, including the clinical differential diagnosis. Please Send a current CBC printout with each request as well.
Volume:
Temperature: Refrigerate
Tube Type: Tissue
Collection Info:
SPECIMEN MUST ARRIVE WITHIN 24 HOURS OF COLLECTION. Size of the tissue sample depends on cellular constituents, but usually,
a 0.5cm x 0.5cm x 0.5cm portion is sufficient. Obtain sample and place directly into a screw-capped, sterile container with approximately 15mL of Hank's balanced salt solution. DO NOT MINCE.
SAMPLES CANNOT BE FROZEN.
Submit a requisition clearly stating "Leukemia / Lymphoma Immunophenotyping" as well as the appropriate collection time
and date of sample.  Submit the name and telephone number of the ordering physician along with a brief diagnostic history of the patient, including the clinical differential diagnosis. Please Send a current CBC printout with each request as well.

Specimen Acceptability

Preferrably all specimens for Leukemia/Lymphoma Immunophenotyping by Flow Cytometry should arrive at the performing lab within 24 hours.

Methods

Flow Cytometry

Clinical Utilities

Analysis by flow cytometry involves the selection of the appropriate panel of antibodies directed against antigens of lymphoid and/or myeloid cell lineages. A hematopathologist selects the necessary panel(s) according to criteria based on clinical information, specimen source, morphologic review and any other instructions conveyed by the referring physician. Accordingly, each case is approached with a specifically-tailored panel.

This procedure is applicable for all cases of acute lymphoblastic or myelogenous leukemias, chronic lymphoproliferative disorders and malignant lymphomas. For Leukemia / Lymphoma Immunophenotyping there is no ordering code, simply send the sample(s) and all relevant paperwork according to the instructions listed below.
Note: For the evaluation of acquired or inherited immunodeficiancies, the T-and-B Cell Quantitation by Flow Cytometry (TBSM) should be ordered.

CPT Codes

88184 for the 1st marker used (technical component)
88185 for each additional marker used (technical component)
88187 for interpretation of 2 to 8 markers (professional component)
88188 for interpretation of 9 to 15 markers (professional component)
88189 for interpretation of 16 or more markers (professional component)

* 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.