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Test ID: CANW
Canavan Disease, Mutation Analysis, ASPA

List Fee Provides the Mayo Medical Laboratories list fee for performing the test

$445.20

For amniotic fluid specimens, the following test will be added at an additional charge:  

$587.80 for #80334 Amniotic Fluid Culture for Genetic Testing     

 

$1,033.00 = Total List Fee       

 

For chorionic villus specimens, the following test will be added at an additional charge:  

$261.10 for #80333 Fibroblast Culture for Genetic Testing     

 

$706.30 = Total List Fee

Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.

This test was developed using an analyte specific reagent. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

81200/ASPA (aspartoacylase (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y23l X)

 

Amniotic Fluid Culture for Genetic Testing

88235-Tissue culture for amniotic fluid (if appropriate)

88240-Cryopreservation (if appropriate)

 

Fibroblast Culture for Genetic Testing

88233-Tissue culture, skin or solid tissue biopsy (if appropriate)

88240-Cryopreservation (if appropriate)

 

For nonparticipating payers:

Canavan Disease, Mutation Analysis, ASPA

83890-Molecular isolation or extraction

83892-Enzymatic digestion

83896 x 5-Nucleic acid probe, each

83900-Amplification, target, multiplex, first 2 nucleic acid sequences

83909-Separation and identification by high-resolution technique

83912-Interpretation and report

83914 x 5-Mutation identification by enzymatic ligation or primer extension, single segment, each segment

 

Amniotic Fluid Culture for Genetic Testing

88235-Tissue culture for amniotic fluid (if appropriate)

88240-Cryopreservation (if appropriate)

 

Fibroblast Culture for Genetic Testing

88233-Tissue culture, skin or solid tissue biopsy (if appropriate)

88240-Cryopreservation (if appropriate)