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Specimen Collection Manual and Test Catalog

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HNPCC CONCURRENT AMBRY

Geisinger Epic Procedure Code:  LAB5257    Geisinger Epic ID:  208015
Test Restriction:  ORDER LIMITED TO GENETICS, HEMATOLOGY/ONCOLOGY, SURGICAL ONCOLOGY, AND LABORATORY.

SPECIMEN COLLECTION
Specimen type: 

Whole Blood, Buccal Swab


Preferred collection container: 
Specimen required: 

3 mL whole blood, 2 mL for pediatrics, or buccal swab


Special notes: 

Blood/saliva from patients with a history of allogenic bone marrow or stem cell transplant should not be used for genetic testing. For these patients, an alternative specimen (e.g. cultured fibroblasts) is required. Testing on blood/saliva from patients with active hematological disease is not recommended. An alternative specimen (e.g. cultured fibroblasts) is recommended.


Patient preparation: 

Transfusion patients: Wait at least 2 weeks after a packed cell/platelet transfusion, and at least 4 weeks after a whole blood transfusion prior to sample collection for testing.
Chemotherapy patients: DNA quality may be affected if patient has received chemotherapy within the last 120 days. Clients will be contacted to provide additional specimen if DNA quality is insufficient.



SPECIMEN PROCESSING
Processing instructions: 

Send whole blood or buccal swab.


Transport temperature: 

Room Temperature.


Specimen stability: 

Room Temperature: 7 days. Refrigerated: 7 days. 



TEST DETAILS
CPT code(s):  81435
Note: The billing party has sole responsibility for CPT coding.  Any questions regarding coding should be directed to the payer being billed.
The CPT codes provided by GML are based on AMA guidelines and are for informational purposes only.

Test includes: 

EPCAM,MLH1,MSH2,MSH6,PMS2


Methodology: 
Deletion/Duplication Analysis
Multiplex Ligation-dependent Probe Amplification
Next Generation Sequencing
Polymerase Chain Reaction (PCR)
Sanger Sequencing
Sequencing
Synonyms: 

Ambry code 8517


Clinical significance: 

Lynch syndrome, previously known as hereditary non-polyposis colorectal cancer (HNPCC), is caused by mutations in the mismatch repair (MMR) genes MLH1, MSH2, MSH6, and PMS2, and EPCAM. Lynch syndrome is the most common hereditary form of colorectal cancer. It affects about 1 in 440 individuals in the U.S.


Doctoral Director(s): 
Randin Nelson MD
Review Date:  04/28/2026

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