Table Page Test
| Gene | Drug Generic Name | Drug Brand Names(S) | Specialty | CPIC Guideline | CPIC Level | PHARMGKB Level of Evidence | PGX on FDA Label |
|---|---|---|---|---|---|---|---|
| ABCB1 | Agomelatine | Valdoxan, Melitor, Thymanax | Psychiatry | A/B | 3 | ||
| ABCB1 | Amaxapine | Asendin | Psychiatry | A/B | 3 | ||
| ABCB1 | Amitriptyline | Elavil | Psychiatry | A/B | 3 |
Left Col Header
| Gene | Drug Generic Name | Drug Brand Names(S) | Specialty | CPIC Guideline | CPIC Level | PHARMGKB Level of Evidence | PGX on FDA Label |
|---|---|---|---|---|---|---|---|
| ABCB1 | Agomelatine | Valdoxan, Melitor, Thymanax | Psychiatry | A/B | 3 | ||
| ABCB1 | Amaxapine | Asendin | Psychiatry | A/B | 3 | ||
| ABCB1 | Amitriptyline | Elavil | Psychiatry | A/B | 3 |
Table with 1st column header only
| Test Name | CNT or NT Panel |
| CPT Code | 81355 |
| Collection | 3-5 Ml |
| Saliva | |
| Stability | Samples should be received by RPRD |
Ordering
Click here to download the Test Requisition Form.
| Test Name | CNT or NT Panel |
| CPT Code | 81355, 81306 |
| Collection | Whole blood (3-5mL peripheral whole blood in ETDA tube) or Saliva in Oragene Dx, Part # OGD-500 |
| Labeling | Must label with patient name plus one additional identifier: date of birth, medical record number, or date of collection |
| Stability | Samples must be received by RPRD within 7 days of collection. Ambient or refrigerated storage is acceptable. |
| Shipping | Ambient temperature. Ship for RPRD receipt on Monday through Friday only. |
| Rejection | Blood sample may be rejected if frozen, hemolyzed, or clotted |
References
- Relling MV, et al. CPIC Guideline for Thiopurines and TPMT and NUDT15. Clin Pharmacol Ther. 2019 May;105(5):1095-1105.
Training table
| Test name | CPT code | DEX-Z code |
|---|---|---|
| CNT Panel (CEP72, NUDT15, TPMT) | 0286U | ZB80H |
| NT Panel (NUDT15, TPMT) | 81335 | ZB8DT |
| AC Panel (ACYP2, CEP72) | 81479 | Z02HI |
| NUDT15 | 81306 | ZB8DU |
| CEP72 | 81479 | Z00R0 |
| CYP2C19 | 81225 | Z00R1 |
| ACYP2 | 81479 | Z02HJ |
| Precision HealthPGx Panel | 81418 | Z00R2 |
| Psych HealthPGx Panel | 81225, 81226, 81479 | Z010Q |
| WPS | 81418 | Z05FQ |