Sign in →

Test ID LBOR0149 DPYD Genotyping

Important Note

This test is rarely covered by insurance.  A Patient Acknowledgement Form for Pharmacogenomics Services is required to accompany the specimen for all Medicare and non-Medicare patients.  In addition, for Medicare patients, and ABN Form should also be submitted.  In the absence of the appropriate signed form(s), the ordering provider/facility will be billed.

For patients with Blue Cross Blue Shield of North Dakota coverage, a separate completed and signed Advance Member Notice is required to accompany the specimen.

Container Type

EDTA

Sterile Container

Specimen Type/Requirements

EDTA Whole Blood

Extracted DNA

Specimen Volume

2.0 – 4.0 mL

Stability

Room Temperature – 72 hours

Refrigerated – 28 days

Frozen – 28 days

Transport Temperature

Refrigerated

Performed Test Frequency

Monday through Friday

Methodology

Allele-specific PCR

Performing Lab

Sanford Molecular

Analytical Time

5 – 7 days

Minimum Volume

1.0 mL

CPT

81232

Interfering Substances

Hemolysis – NA

Lipemia – NA

Instructions

This testing requires that a Patient Acknowledgement Form for
Pharmacogenomics Services
must be filled out
for all Medicare and non-Medicare patients  and submitted with
the sample for testing to be performed. In addition, Medicare
patients require an
ABN Form
to also be submitted with the specimen.

 

For patients with Blue Cross Blue Shield of North Dakota
coverage, a separate completed and signed Advance Member Notice is required to
be submitted with the specimen.

 

All specimens should be sent in the original container and
should not be aliquoted to another tube. In addition, the specimen
submitted should ONLY be used for this testing and should not be
shared with any other testing that would also utilize this specimen
type.

Additional Information

Uses for Test include:

 

  • Estimate genetic risk of dose-related toxicity for drugs
    metabolized by DPYD including but not limited to 5-fluorouracil
    (5-FU) and capecitabine.
  • Identify genotypes indicative of a personal or family history
    of an adverse drug reaction or for drugs metabolized by DPYD and
    thereby guide drug and dose selection.

The test includes the identification of the following variant
alleles:

DPYD*2, *13, rs67376798 (the SNP rs57376798 has not been given a
* allele designation).

 

See Dihydropyrimidine
Dehydrogenase (DPYD) Genotyping Medical Providers
form for
additional information.

See Dihydropyrimidine
Dehydrogenase (DPYD) Genotyping Technical Specifications
for
additional information.

AKA

Fluoropyrimidine

5-Fluorouracil

Capecitabine