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Test ID: CFTRK
CFTR Gene, Known Mutation

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

$209.70

One of the following test(s) will be added at an additional charge:  

$289.60 for #82555 DNA Sequence, Follow-up Analysis  

$289.60 for #89859 CFTR Gene Large Deletion/Duplication 

 

$499.30 = Total List Fee 

 

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

$587.80 for #80334 Amniotic Fluid Culture for Genetic Testing     

 

$1,087.10 = 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     

 

$760.40 = 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 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 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.

CFTR Gene, Known Mutation

81221-CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants

 

CFTR Gene, Large Deletion/Duplication

81222-CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants (if appropriate)

 

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:

CFTR Gene, Known Mutation

83891-Isolation or extraction of highly purified nucleic acid

83892 x 2-Enzymatic digestion

83894 x 2-Separation by gel electrophoresis

83898 x 2-Amplification, target, each nucleic acid sequence

83909 x 4-Separation and identification by high-resolution technique

83912-Interpretation and report

 

DNA Sequence, Follow-up Analysis

83892-Enzymatic digestion (if appropriate)

83894-Separation by gel electrophoresis (if appropriate)

83898-Amplification, target, each nucleic acid sequence (if appropriate)

83909 x 2-Separation and identification by high-resolution technique (if appropriate)

 

CFTR Gene, Large Deletion/Duplication

83900-Amplification, target, multiplex, first 2 nucleic acid sequences (if appropriate)

83909-Separation and amplification by high resolution technique (if appropriate)

83914 x 31-Mutation identification by enzymatic ligation or primer extension, single segment, each segment (if appropriate)

 

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)