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Unit Code 87995:
Imatinib Mesylate Responsive Genes, Locus Anomalies, FISH

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List Fee

$499.40

 

(When chromosome analysis procedure is performed,

it is charged separately.)

 

An additional fee will be charged if 1 of the following is ordered:

$50.00 for #80024 "One Additional FISH Probe" (if appropriate)

$75.00 for #80025 "Two Additional FISH Probes" (if appropriate)  

$100.00 for #87825 "Three Additional FISH Probes" (if appropriate)

$125.00 for #80026 "Four Additional FISH Probes" (if appropriate)

$150.00 for #87826 "Five Additional FISH Probes" (if appropriate)

$175.00 for #87827 "Six Additional FISH Probes" (if appropriate)

$200.00 for #87828 "Seven Additional FISH Probes" (if appropriate)

$225.00 for #87829 "Eight Additional FISH Probes" (if appropriate)

$250.00 for #87830 "Nine Additional FISH Probes" (if appropriate)

$275.00 for #87831 "Ten Additional FISH Probes" (if appropriate)

$300.00 for #87832 "Eleven Additional FISH Probes" (if appropriate)

$325.00 for #87833 "Twelve Additional FISH Probes" (if appropriate) 

Test Classification

This test was developed and its performance characteristics

determined by Laboratory Medicine and Pathology, Mayo Clinic.

This test has not been cleared or approved by the U.S. Food

and Drug Administration.

CPT Code Information

"Imatinib Mesylate Responsive Genes, Locus Anomalies, FISH"

88271x2/DNA probe, each

88275/Interphase in situ hybridization

88291/Interpretation and report

 

"One Additional Fluorescence In Situ Hybridization (FISH) Probe"

88271/DNA probe, each (if appropriate)

88275/Interphase in situ hybridization (if appropriate)

 

 "Two Additional Fluorescence In Situ Hybridization (FISH) Probes"

88271/x2 DNA probe, each (if appropriate)

88275/Interphase in situ hybridization (if appropriate)

 

"Three Additional Fluorescence In Situ Hybridization (FISH) Probes"

88271/x3 DNA probe, each (if appropriate)

88275/Interphase in situ hybridization (if appropriate)

 

 "Four Additional Fluorescence In Situ Hybridization (FISH) Probes"

88271/x4 DNA probe, each (if appropriate)

88275/x2 Interphase in situ hybridization (if appropriate)

 

"Five Additional Fluorescence In Situ Hybridization (FISH) Probes"

88271/x5 DNA probe, each (if appropriate)

88275/x2 Interphase in situ hybridization (if appropriate)

 

"Six Additional Fluorescence In Situ Hybridization (FISH) Probes"

88271/x6 DNA probe, each (if appropriate)

88275/x3 Interphase in situ hybridization (if appropriate)

 

 "Seven Additional Fluorescence In Situ Hybridization (FISH) Probes"

88271/x7 DNA probe, each (if appropriate)

88275/x3 Interphase in situ hybridization (if appropriate)

 

"Eight Additional Fluorescence In Situ Hybridization (FISH) Probes"

88271/x8 DNA probe, each (if appropriate)

88275/x4 Interphase in situ hybridization (if appropriate)

 

"Nine Additional Fluorescence In Situ Hybridization (FISH) Probes"

88271/x9 DNA probe, each (if appropriate)

88275/x4 Interphase in situ hybridization (if appropriate)

 

"Ten Additional Fluorescence In Situ Hybridization (FISH) Probes"

88271/x10 DNA probe, each (if appropriate)

88275/x5 Interphase in situ hybridization (if appropriate)

 

"Eleven Additional Fluorescence In Situ Hybridization (FISH) Probes"

88271/x11 DNA probe, each (if appropriate)

88275/x5 Interphase in situ hybridization (if appropriate)

 

"Twelve Additional Fluorescence In Situ Hybridization (FISH) Probes"

88271/x12 DNA probe, each (if appropriate)

88275/x6 Interphase in situ hybridization (if appropriate)

Key