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X-linked Adrenoleukodystrophy (X-ALD) Full Gene Sequencing

X-linked Adrenoleukodystrophy (X-ALD) Full Gene Sequencing

Laboratory Fee Schedule

Procedure #

CPT: 81405

 

Synonym(s): X-ALD
Requisition Form

G-1B 

(G-1B form ordering information)
Test Description X-linked Adrenoleukodystrophy (X-ALD) Full Gene Sequencing
Pre-Approval Needed N/A
Supplemental Information Required N/A
Supplemental Form(s) N/A
Performed on Specimens from (sources) Human
Sample/Specimen Type for Testing
  • Dried filter paper blood spots
  • EDTA anticoagulated (purple top tube) whole blood
Minimum Volume/Size Required
 
  • One ½ inch dried filter paper blood spot
  • 1mL whole blood
Storage/Preservation Prior to Shipping Dried filter paper blood specimens
  • Allow card to dry thoroughly at room temperature in a horizontal position for at least 3 hours. Do NOT allow specimen to touch any surface. 
  • Cover dried specimen with attached flap.
Whole blood specimens 
  • Refrigerate whole blood samples until shipment.
Transport Medium EDTA acceptable for whole blood
Specimen Labeling

Ship all specimens according to Dangerous Good Regulations, IATA, and/or CFR 49.

DRIED FILTER PAPER BLOOD SPECIMENS

  • U.S. Postal regulations require Double containment of dried blood filter paper specimens. Ensure specimens are thoroughly dried prior to placing in envelope.
  • 1st containment: Use the attached wrap-around cover with printed universal biohazard symbol. Do not put biohazard labels on outside of envelope. 
  • 2nd containment:  Place dried filter paper blood specimen in an envelope that is not hermetically sealed. Do not put specimens in plastic bags.
  • Ship as soon as possible; within 24hrs of collection. 
  • Avoid temperatures greater than 100°F. 

WHOLE BLOOD SHIPPING REQUIREMENT 

  • Refrigerate sample until shipment.
  • Whole blood specimens must be shipped overnight at room temperature or refrigerated and received within 7 days of collection. 
  • U.S. Postal regulations require Triple containment: See instructions on how to triple contain a specimen for shipping.
Method PCR Amplification and Sanger Sequencing
Turn-around Time 14 working days
Common Causes for Rejection
  • Use of expired specimen collection device 
  • No date of collection provided
  • Coagulated blood or insufficient amount of blood 
  • Patient information incomplete or invalid 
  • Patient name on specimen does not match name on request form.

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Additional Information Interpretation:  Available on the result report.
Diagnostic Information: X-ALD DNA testing is performed in support of the Newborn Screening Program at DSHS and for other individuals. X-ALD Sanger sequencing methodology can detect approximately 97% of the known variants in this gene. Test results should not be used as a diagnostic test, but should be interpreted in the context of clinical findings, family history, and other laboratory data.
Additional information for specimen collection: