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Test Code PSYGP Psychotropic Pharmacogenomics Gene Panel, Varies


Necessary Information


Psychotropic Pharmacogenomics Gene Panel Prior Authorization Ordering Instructions is required. See Special Instructions.



Specimen Required


Prior Authorization is available for this test. Submit the required form with the specimen.

 

Submit only 1 of the following specimens:

 

Specimen Type: Whole blood

Container/Tube: Lavender top (EDTA)

Specimen Volume: 3 mL

Collection Instructions:

1. Invert several times to mix blood.

2. Send specimen in original tube.

Specimen Stability Information: Ambient (preferred) 9 days/Refrigerated 30 days

 

Specimen Type: Saliva

Patient Preparation: Patient should not eat, drink, smoke, or chew gum 30 minutes prior to collection.

Supplies: Saliva Swab Collection Kit (T786)

Specimen Volume: 1 swab

Collection Instructions: Collect and send specimen per kit instructions.

Specimen Stability Information: Ambient 30 days

Additional Information: Due to lower concentration of DNA yielded from saliva, testing cannot proceed to reflex testing for CYP2D6 sequencing and will stop after initial testing is complete.

 

Specimen Type: DNA

Container/Tube: 2 mL screw top tube

Specimen Volume: 100 mcL (microliters)

Collection Instructions:

1. The preferred volume is 100 mcL at a concentration of 50 ng/mcL.

2. Include concentration and volume on tube.

Specimen Stability Information: Frozen (preferred) 1 year/Ambient/Refrigerated


Forms

1. New York Clients-Informed consent is required. Document on the request form or electronic order that a copy is on file. The following documents are available in Special Instructions:

-Informed Consent for Genetic Testing (T576)

-Informed Consent for Genetic Testing-Spanish (T826)

2. If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.

3. Psychotropic Pharmacogenomics Gene Panel Prior Authorization Ordering Instructions in Special Instructions.

Useful For

Individualizing selection and dosage of medications prescribed for treatment of depression and other psychiatric disorders based on genetic variation

 

Identifying genetic variation in genes known to be associated with response and/or risk of toxicity with psychotropic medications

 

Evaluating patients who have failed therapy with selective serotonin reuptake inhibitors (SSRIs)

 

Evaluating patients with treatment-resistant depression

 

Predicting response time to improvement with SSRIs

Testing Algorithm

If a specimen requires follow-up for CYP2D6, then reflex testing will be performed as appropriate at an additional charge.

 

See CYP2D6 Comprehensive Cascade Testing Algorithm in Special Instructions.

Method Name

Real-Time Polymerase Chain Reaction (RT-PCR) with Allelic Discrimination Analysis

 

Qualitative Allele-Specific Real-Time Polymerase Chain Reaction (PCR)

 

PCR Followed by Sizing Analysis

Reporting Name

Psychotropic PGx Panel

Specimen Type

Varies

Specimen Minimum Volume

Blood: 1 mL
Saliva: 1 swab

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Varies

Reference Values

An interpretive report will be provided.

Day(s) and Time(s) Performed

Monday through Thursday; 8 a.m.

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics 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

81479

81226

81225

81227

81230

81231

81291

81381 x 2

LOINC Code Information

Test ID Test Order Name Order LOINC Value
PSYGP Psychotropic PGx Panel 94753-1

 

Result ID Test Result Name Result LOINC Value
602687 ADRA2A rs1800544 Genotype 94401-7
602707 ANKK1 rs1800497 Genotype 94402-5
602689 CHRNA3 rs1051730 Genotype 94403-3
602691 COMT rs4680 Genotype 74511-7
602692 CYP1A2 Genotype 72884-0
602693 CYP1A2 Phenotype 94254-0
602694 CYP2B6 Genotype 72882-4
602695 CYP2B6 Phenotype 79720-9
602696 CYP2C19 Genotype 57132-3
602697 CYP2C19 Phenotype 79714-2
602698 CYP2C9 Genotype 46724-1
602699 CYP2C9 Phenotype 79716-7
602700 CYP2D6 Genotype 40425-1
602701 CYP2D6 Phenotype 79715-9
602702 CYP3A4 Genotype 81139-8
602703 CYP3A4 Phenotype 81145-5
602704 CYP3A5 Genotype 81140-6
602705 CYP3A5 Phenotype 79717-5
602706 DRD2 rs1799978 Genotype 94411-6
602708 EPHX1 rs2234922 Genotype 94412-4
602709 GRIK4 rs1954787 Genotype 94413-2
602776 HLA-A*31:01 Genotype 79712-6
602777 HLA-B*15:02 Genotype 57979-7
602710 HTR2A rs7997012 Genotype 93190-7
602711 HTR2C rs3813929 Genotype 93191-5
602712 HTR2C rs1414334 Genotype 93192-3
602713 MTHFR Genotype 94414-0
602715 OPRM1 rs1799971 Genotype 94415-7
602716 SCN1A rs3812718 Genotype 94416-5
602779 SLC6A4 5HTTLPR Genotype 94417-3
602717 UGT2B15 rs1902023 Genotype 94418-1
602718 Interpretation 69047-9
602719 Additional Information 48767-8
602720 Method 85069-3
602721 Disclaimer 62364-5
602722 Reviewed by 18771-6

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
2D6S1 CYP2D6 FULL GENE SEQUENCE No, (Bill Only) No
2D6S2 CYP2D6 GEN CYP2D6-2D7 HYBRID No, (Bill Only) No
2D6S3 CYP2D6 GEN CYP2D7-2D6 HYBRID No, (Bill Only) No
2D6S4 CYP2D6 NONDUPLICATED GENE No, (Bill Only) No
2D6S5 CYP2D6 5' GENE DUP/MLT No, (Bill Only) No
2D6S6 CYP2D6 3' GENE DUP/MLT No, (Bill Only) No