Bone Marrow without Flow Cytometry
GENERAL INFORMATION
Test Name:
Bone Marrow without Flow Cytometry
PC/NPS Test Code:
BM CONSULT
CPT Code(s):
CPT coding for bone marrow studies varies depending on testing required, which is dependent on complexity of the case and the type and number of samples submitted.
Methodology:
NOTE: THIS IS THE TYPICAL BONE MARROW TEST TO ORDER FOR WVCI BONE MARROWS ON RESEARCH PATIENTS.
Methodology:
Microscopic examination of stained bone marrow and blood slides. Wright-Geimsa, H&E and iron stains are routinely performed on all bone marrows.
Days of Week Performed:
M,Tu, W, Th, F. STAT weekend preliminary testing available by arrangement.
Routine TAT:
2-3 days (excluding weekends and holidays)
Reference Range(s):
BM studies are reported with a pathologist interpretation of findings.
Clinical Utility:
Required for diagnosis of most leukemias, myelodysplasia, and myeloma. Useful for diagnosis or staging of lymphomas. Often performed to evaluate unexplained low or high cell counts (WBC, RBC and/or platelets) in the blood. Periodic repeat BM studies may be performed post-treatment for hematologic malignancies to evaluate remission or progression.
COLLECTION AND HANDLING:
Collection Instructions:
1. BM slides prepared fresh. 2-3 pull slides and 2-3 push slides from the aspirate. Also submit 2-3 touch preps from the BM biopsy.
2 BM in EDTA (lavender tube). For flow cytometry and/or PCR/gene sequencing if needed.
3. BM in heparin (green tube). For cytogenetics and/or FISH testing if needed.
4. BM in RPMI. For flow cytometry if testing will be delayed beyond 24 hours.
5. Blood slides. 2 unstained slides preferred.
6. Blood in EDTA (lavender). Or provide a copy of the automated CBC results from within 48 hours of the BM collection.
7. BM core biopsy in formalin. If an aspirate cannot be obtained, place the biopsy in saline or RPMI instead of formalin.
8. BM clot in formalin. Keep blood and bone marrow slides in a separate bag from formalin containers. Formalin results in later discoloration of slides during staining.
Collection Containers:
N/A
Specimen Transport Requirements:
Refrigeration is preferred if testing will not be done within 1-2 hours.
Specimen Labeling:
Label all specimens with 2 patient specific identifiers. Also note either “Bone Marrow” or “Blood” on each vacutainer tube.
Rejection Criteria:
Insufficient bone marrow for interpretation (eg, ‘dry tap’). Frozen specimens. Very old specimens with no freshly prepared slides submitted. NOTE: Given the difficulty of recollection, an attempt will be made to salvage sub-optimal specimens before initiating a recall. In such cases, the limitations of the study will be noted in the pathologist interpretation if the case is reported.
Specimen Retention Time:
All surplus liquid samples are saved 7 days in the refrigerator. Blood and bone marrow slides are saved for at least 10 years.
Appropriate Clinical Data:
N/A
Test Item:
Item
Path:
Lab/Lists/PCNPS Test Menu
