Geisinger Medical Laboratories/Geisinger Proven Diagnostics Test Catalog

Order Display Name: Geisinger Epic Procedure Code Or ID CPT Code:  

BONE MARROW WITH REFLEX TESTING

ORDERING INFORMATION:
Geisinger Epic Procedure Code: 100004         Geisinger Epic ID: 17706

SPECIMEN COLLECTION
Specimen type:
Bone marrow aspirate, touch imprints, core biopsy, and/or clot section
Specimen required:
CBCD, bone marrow aspirate/touch imprints, core biopsy/clot section.

Preferred collection types:

  • Bone marrow aspirate:
    • Nine (9)unfixed/unstained air dried bone marrow aspirate and/or touch imprint slides; any remaining aspirate in a lavender-top (K2 EDTA) tube labeled as "bone marrow aspirate for slide prep" (please use first 1-2 mL of aspirate only.
    • Two (2) green-top (sodium heparin) tubes with 2-3 mL (minimum) of bone marrow aspirate labeled "bone marrow aspirate."
    • Two (2) lavender-top (K2 EDTA) tubes with 2-3 mL (minimum) of bone marrow aspirate labeled "bone marrow aspirate molecular."  
  • Bone marrow tissue biopsy and clot section
    • Bone marrow plug in blue (B-fixative) tube.
    • Blood clot (only if biopsy is inadequate) in blue (B-fixative) tube or formalin.
    • Bone marrow or blood clot in RPMI acceptable (not available at all collection location).
  • Peripheral blood
  • One (1) lavender-top K2 (EDTA) tube labeled as "blood" or a blood smear slide made within 48 hours of bone marrow biopsy (please include CBC analyzer printout).
     
Alternate collection type: Bone marrow tissue biopsy and clot section are acceptable in RPMI (not available at all collection location).
Special notes:
See Bone Marrow Specimen Submission Guidelines for complete details.

Bone marrows collected at hospital locations are to be scheduled in advance with the Hematology Department at each site to ensure proper collection and timely transportation of specimen to GMC for processing. Call Client Services at 1-800-695-6491 for bone marrow transport kits if located at an outside facility. Bone marrows performed during non-business hours must be reviewed and approved by CP pathologist on call.

Bone marrow specimen collection instructions (video)

This bone marrow request form must accompany specimen

SPECIMEN PROCESSING
Specimen processing instructions:
Package bone marrow biopsy and clot sections in a separate bag to make sure no formalin/B-fixative is near the unstained slides as this will cause artifact on the slides. 
Transport temperature:
Peripheral blood EDTA: Refrigerated (preferred) or room temperature.
Bone marrow aspirate EDTA: Refrigerated.
Bone marrow aspirate sodium heparin: Refrigerated.
Air dried slides: Room temperature.
Fixed tissue in formalin: Room temperature.
Fresh tissue in RPMI: Refrigerated.
Fresh tissue without formalin: Refrigerated.
Specimen stability:
CBCD: Refrigerated: 16 hours. Room temperature: 8 hours.
Bone marrow aspirate flow cytometry: Stable for 48 hours at room temperature.
Bone marrow aspirate cytogenetics/FISH/molecular: 3-7 days (depends on study).
Tissue: Stability varies depending if fixed or fresh.
Rejection criteria:
SPECIMENS ARE NEVER REJECTED. SEE SUPERVISOR.

TEST DETAILS
CPT code(s):
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:
Morphologic peripheral blood and bone marrow interpretation by a pathologist. Reflex ancillary studies including; flow cytometry, cytogenetics (chromosome analysis), FISH studies, and molecular studies (including next generation sequencing) will be ordered by the pathologists as appropriate based on the biopsy.
Synonyms:
Plug, Aspriate, Touch imprints, Clot sections, Bone, Marrow
BM
Clinical significance:
Bone marrow specimens are obtained by the clinical provider to assess (1) hematologic abnormalities that cannot be explained by available clinical and laboratory data, (2) stage malignant lymphomas and metastatic tumors, and (3) to monitor the patient’s therapeutic response to administered therapies. Meaningful interpretation of a bone marrow specimen requires adequate and well-prepared specimens.
Doctoral Director(s:)
Michelle Grant DO    
Review Date: 03/24/2020

Performing Locations

Geisinger Medical Center

Performing laboratory: Hematology
Technical Lead: Margaret Knowles-Tuchman
Frequency: Daily, Monday-Friday. Bone marrows performed during non-business hours must be reviewed and approved by CP pathologist on call.
Performed stat? Yes

Geisinger Wyoming Valley Medical Center

Performing laboratory: ATL+
Technical Lead: Julia Bell    
Frequency: Daily, Monday-Friday. Bone marrows performed during non-business hours must be reviewed and approved by CP pathologist on call.    
Performed stat? Yes

Geisinger Community Medical Center

Performing laboratory: Hematology
Technical Lead: Renee Bordo, Robert Furcon  
Frequency: Daily, Monday-Friday. Bone marrows performed during non-business hours must be reviewed and approved by CP pathologist on call.    
Performed stat? Yes
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