Test Code CTI-M 
Methodology Includes 2 - banded karyotypes, analysis of 20 or more metaphases, and other techniques when required. 
Description Useful as a second order testing for chromosomal anomalies, as a follow-up test when results from peripheral blood are inconclusive, and when peripheral blood sampling is poor or not possible.

NOTE: This test, when ordered on Medicare patients, is subject to the CMS Medicare Coverage Issues Manual (MCIM) Diagnostic Services policy "Cytogenetic Studies". Please verify that the diagnosis code (ICD-9) you have chosen demonstrates medical necessity for the test as documented in the physician's patient record. The CMS web site or the NorDx Limited Coverage Documentation Guide are available to assist you with this verification. A properly executed Advance Beneficiary Notice (ABN) must be submitted with the specimen if medical necessity is not demonstrated by the ICD-9 code chosen. 

Specimen Wash biopsy site with an antiseptic soap (e.g. pHisoHex®). Thoroughly rinse area with sterile water. Do not use alcohol or iodine preparations. A local anesthetic may be used. Biopsy specimens are best taken by punch biopsy to include full thickness of dermis. Biopsy should be 4 mm in diameter. Place biopsy in a screw-capped, sterile container with sterile Hank's balanced salt solution, Ringer's solution, or normal saline. (Hank's balanced salt solution is supplied by NorDx.) Do not handle with hands. Label container with patient's name and laboratory control number. Send specimen refrigerated. SPECIMEN CANNOT BE FROZEN. 
Reference Values 46, XX or 46, XY. No apparent chromosome abnormality. 
Analytic Time 10 - 21 Days 
Day(s) Test Set Up Monday through Sunday 
CPT Code(s) 88233  Tissue culture for chromosome analysis
88262  Count 15 - 20 cells, 2 karyotypes, with banding
88291  Interpretation and report