Test ID PGXQP Focused Pharmacogenomics Panel, Varies
Specimen Required
Submit only 1 of the following specimens:
Specimen Type: Whole blood
Container/Tube: Lavender top (EDTA)
Specimen Volume: 3 mL
Collection Instructions:
1. Invert several times to mix blood.
2. Send whole blood specimen in original tube. Do not aliquot.
Specimen Stability Information: Ambient (preferred) 9 days/Refrigerated 30 days
Specimen Type: Saliva
Patient Preparation: Patient should not eat, drink, smoke, or chew gum 30 minutes prior to collection.
Supplies: Saliva Swab Collection Kit (T786)
Specimen Volume: 1 Swab
Collection Instructions: Collect and send specimen per kit instructions.
Additional Information: Due to lower concentration of DNA yielded from saliva, testing cannot proceed to reflex testing for 2D6 sequencing and will stop after initial testing is complete.
Specimen Stability Information: Ambient 30 days
Specimen Type: Extracted DNA
Container/Tube: 2-mL screw top tube
Specimen Volume: 100 mcL (microliters)
Collection Instructions:
1. The preferred volume is 100 mcL at a concentration of 50 ng/mcL.
2. Provide concentration of DNA and volume on tube.
Specimen Stability Information: Frozen (preferred) 1 year/Ambient/Refrigerated
Forms
1. New York Clients-Informed consent is required. Document on the request form or electronic order that a copy is on file. The following documents are available:
-Informed Consent for Genetic Testing (T576)
-Informed Consent for Genetic Testing-Spanish (T826)
2. If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-Neurology Specialty Testing Client Test Request (T732)
-Therapeutics Test Request (T831)
-Cardiovascular Test Request (T724)
Useful For
Preemptive or reactive genotyping of patients for pharmacogenomic purposes
Providing an assessment for genes with strong drug-gene associations
Special Instructions
Method Name
Real Time Polymerase Chain Reaction (RT-PCR) with Allelic Discrimination Analysis/PCR followed by DNA Sequencing, when appropriate
Reporting Name
Focused Pharmacogenomics Panel, VSpecimen Type
VariesSpecimen Minimum Volume
Whole Blood: 1 mL
Saliva, extracted DNA: see Specimen Required
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Varies | Varies | |
Reference Values
An interpretive report will be provided.
Day(s) Performed
Monday through Friday
Report Available
3 to 14 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| PGXQP | Focused Pharmacogenomics Panel, V | 82118-1 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 610185 | CYP1A2 Genotype | 72884-0 |
| 610186 | CYP1A2 Phenotype | 94254-0 |
| 610187 | CYP2C19 Genotype | 57132-3 |
| 610188 | CYP2C19 Phenotype | 79714-2 |
| 610570 | CYP2C19 Activity Score | In Process |
| 610189 | CYP2C9 Genotype | 46724-1 |
| 610190 | CYP2C9 Phenotype | 79716-7 |
| 610571 | CYP2C9 Activity Score | In Process |
| 610191 | CYP2D6 Genotype | 40425-1 |
| 610192 | CYP2D6 Phenotype | 79715-9 |
| 610572 | CYP2D6 Activity Score | In Process |
| 610193 | CYP3A4 Genotype | 81139-8 |
| 610194 | CYP3A4 Phenotype | 81145-5 |
| 610195 | CYP3A5 Genotype | 81140-6 |
| 610196 | CYP3A5 Phenotype | 79717-5 |
| 610197 | SLCO1B1 Genotype | 93412-5 |
| 610198 | SLCO1B1 Phenotype | 79722-5 |
| 610199 | Warfarin CYP2C9 Genotype | 46724-1 |
| 610201 | Warfarin VKORC1 Resistance Genotype | 50722-8 |
| 610200 | Warfarin VKORC1 Promoter Genotype | 50722-8 |
| 614000 | Warfarin CYP2C9 and VKORC1 Promoter Phenotype | 54451-0 |
| 610202 | Warfarin CYP4F2 *3 Genotype | 93197-2 |
| 610203 | Warfarin rs12777823 Genotype | 93198-0 |
| 610204 | Interpretation | 69047-9 |
| 610205 | Additional Information | 48767-8 |
| 610206 | Method | 85069-3 |
| 610207 | Disclaimer | 62364-5 |
| 610208 | Reviewed by | 18771-6 |
CPT Code Information
0029U
0071U (if appropriate)
0072U (if appropriate)
0073U (if appropriate)
0074U (if appropriate)
0075U (if appropriate)
0076U (if appropriate)
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| 2D61Z | CYP2D6 Full Gene Sequence | No, (Bill Only) | No |
| 2D62Z | CYP2D6 GEN CYP2D6-2D7 Hybrid | No, (Bill Only) | No |
| 2D63Z | CYP2D6 GEN CYP2D7-2D6 Hybrid | No, (Bill Only) | No |
| 2D64Z | CYP2D6 Nonduplicated Gene | No, (Bill Only) | No |
| 2D65Z | CYP2D6 5' Gene DUP/MLT | No, (Bill Only) | No |
| 2D66Z | CYP2D6 3' Gene DUP/MLT | No, (Bill Only) | No |
Testing Algorithm
If a specimen requires follow-up for CYP2D6, then reflex testing will be performed as appropriate at an additional charge.
For more information see CYP2D6 Comprehensive Cascade Testing Algorithm.