Test name:  Oncology FISH
Also known as: Fluorescence in situ hybridization (FISH)


Indications:

  • Leukemia
  • Lymphoma
  • Malignant hematologic disorders
  • Solid tumor

Test Information: Fluorescence in situ hybridization (FISH) in oncology is used to detect deletions, duplications, and/or rearrangements of chromosome material known to be associated with specific types of cancer.
See “Additional links” below for lists of FISH panels available by testing indication. 


 

Additional tests available on oncology samples (refer to additional pages for details):

Cancer Chromosome Analysis
Cancer Microarray
Molecular Pathology at Regional Pathology Services including RT-PCR for specific neoplasm


Specimen requirements*: Room temperature, DO NOT FREEZE
Test kits are available – please contact the laboratory
*HGL will attempt to run tests on smaller volume samples 

  • Bone Marrow: 2 ml bone marrow in a 3 ml sodium heparin tube
    Instructions: Bone marrow from 1st or 2nd aspirate using a sodium-heparinized syringe
  • Cancer Blood: 5 ml peripheral blood in a 5 ml sodium heparin tube
  • Lymph Node / Solid Tumor Tissue: ≥5 mm3 of lymph node or representative tumor tissue in culture media
  • Paraffin Tissue for FISH Studies (PathVysion® HER-2/neu, Lymphoma, Solid Tumor):
    Please send the following:
    1) 2-3 unstained 4-5 micron sections of formalin-fixed, paraffin embedded tissue on positively charged (+) slides for each chromosomal target
    2) An H&E slide with the invasive tumor area delineated with a marker (please do not mark on the unstained slides with marker), if applicable
    3) A copy of the pathology report
  • Urine / Bladder Washings (UroVysion®): 30 ml urine in a sterile container
    Instructions: Include a copy of the Pathology Report 

CPT codes: Due to the complexity, call 402-559-5070, option 3, if clarification is needed.

  • UroVysion®:88271(x4), 88275, 88291
  • Paraffin HER-2/neu (PathVysion®): 83892, 88271(x2), 88274, 88291
  • Interphase FISH: Requires CPT Codes from BOTH Section I and Section II

SECTION I

One chromosomal target: 88271(x1-3), 88275
For each additional chromosomal target: 88271(x1-2), 88275(x0-1) plus the “One chromosomal target” CPT codes listed above.
Diagnosis-specific FISH panels:

Adult Acute Lymphocytic Leukemia/Lymphoma(ALL):  88271(x4), 88275(x2)
Pediatric Acute Lymphocytic Leukemia/Lymphoma (ALL):  88271(x9-14), 88275(x4-6)
T-cell Acute Lymphocytic Leukemia/Lymphoblastic Lymphoma (T-cell ALL): 88271(x6), 88275(x3)
Acute Myeloid Leukemia (AML):  88271(x1-14), 88275(x1-7)
Chronic Lymphocytic Leukemia (CLL):  88271(x8), 88275(x4)
Chronic Myeloid Leukemia (CML):  88271(x3), 88275
Chronic Myeloid Leukemia (CML) – FISH only:  88271(x6), 88275(x2)
Eosinophilia:  88271(x4), 88275(x3)
Marginal Zone:  88271(x8), 88275(x4)
Multiple Myeloma (MM):  88271(x10-16), 88275(x4-7)
Myelodysplastic Syndrome (MDS):  88271(x9), 88275(x4)
Myeloproliferative Disorder (MPD):  88271(x10), 88275(x4)
Myelodysplastic/Myeloproliferative (MDS/MPD):  88271(x14), 88275(x6)
Non-Hodgkin Lymphoma (NHL):  88271(x4), 88275(x3)

PLUS

SECTION II

Cultured (fresh) specimens (bone marrow, cancer blood, lymph nodes, etc.): 88237 and 88291 plus the corresponding CPT codes for the number of chromosomal targets or diagnosis-specific FISH panel(s) listed above.

Paraffin-embedded specimens: 83892 and 88291 plus the corresponding CPT codes for the number of chromosomal targets or diagnosis-specific FISH panel(s) listed above.

NOTE: FISH analysis on metaphase chromosomes (CPT: 88272) may be necessary on any case based on identified chromosome abnormality or testing indication, and this charge will be added accordingly.


Pricing: Contact the laboratory billing staff for current costs

Shipping & Handling

Required forms:

Oncology Test Request Form*,
PathVysion® HER-2/neuTest Request Form*,
*Advanced Beneficiary Notice (ABN) is REQUIRED for UroVysion® & PathVysion® HER-2/neu

Turn-around time:

  • Bone Marrow: 5-7 days
  • Cancer Blood: 5-7 days
  • Lymph Node: 15-25 days
  • Paraffin Tissue for FISH (PathVysion® HER-2/neu,Lymphoma, Solid Tumor): 5-10 days
  • Solid Tumor Tissue: 20-26 days
  • Urine / Bladder Washings (UroVysion®): 5-10 days

Additional links:  Oncology FISH Probes/Panels List

revised: 6-3-13

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