2020 MORL Test Catalog/Menu- No Weekend Deliveries
2020 MORL Hearing Loss Test Requisition Form
2020 MORL Kidney Testing Requisition Form
2020 HEAR VUS -Request Evaluation Form
| Hearing Genetic Testing | Test Codes | CPT Codes | Cost | TAT |
|---|---|---|---|---|
| OtoSCOPE® panel | OTOSC08 | 81430, 81431 | $1650 | 6 weeks |
| Usher panel: USH1 genes: MYO7A, USH1C, CDH23, PCDH15, USHIG, CIB2; USH2 genes: USH2A, GPR98, WHRN (DFNB31); USH3 genes: CLRN) |
USH01 | 81404(x2), 81407(x3), 81408 (x2), 81479(x3) |
$1650 | 6 weeks |
| GJB2/GJB6 (Connexin 26/30) | GJB2_6 | 81252 / 81254 | $356 | 8 weeks |
| GJB2/GJB6 (Connexin 26/30) familial | GJB2_6F | 81253 | $220 | 8 weeks |
| MTRNR1- C1494T and A1555G variants | MTRNR1 | 81401 – MTRNR1 | $185 | 8 weeks |
| MTTL1-A3243G variant | MTTL1 | 81401 – MTTL1 | $185 | 8 weeks |
| MTTS1-A7445G variant | MTTS1 | 81401 – MTTS1 | $185 | 8 weeks |
| OtoSCOPE® Familial Variant Testing (cost is per person/per gene) | OTOSCFAM | 81403 | $220 | 8 weeks |
| HEAR VUS Program: Variant reclassification program for qualifying families | HEARVUS | 81403 | --- | 6 weeks |
|
Gene Specific Testing: Please contact MORL prior to ordering to discuss availability, test methods, and cost. |
Single gene testing may be available for hearing loss genes included on the current OtoSCOPE panel. | Please contact MORL | Please contact MORL | |
| Kidney Genetic Testing | Test Codes | CPT Codes | Cost | TAT |
| Genetic Renal Panel (appropriate for patients with TMA, TTP, aHUS, DDD and C3GN) - genes included: CFH, CFI, MCP, CFB, CFHR5, C3, THBD, ADAMTS13, PLG, DGKE, MMACHC, G6PD, and MLPA |
GRP07 | 81479, 81405 |
$3000 | 3 weeks |
| MLPA (screening the CFH-CFHR5 genomic region) | MLPA02 | 81405 | $686 | 3 weeks |
| Genetic Renal Panel/Sanger Familial Variant Testing (cost is per person/per gene) | GRPFAM | 81403 | $220 | 2 weeks |
| Functional/Biomarker Tests - Panels | Test Codes | CPT Codes | Cost | TAT |
| TMA Functional Panel (11 tests - FH autoantibody, Hemolytic Assay, CH50eq, APFA, Bb, FH, FI, FB, C3, C4, & sC5b-9.) |
07TMAFP | 83516, 83520, 86160 (x6), 86161(x2), 86162 | $2389 | 4 weeks |
| C3G Functional Panel (includes the three micro-panels below [Complement Antibody Panel, Complement Biomarker Panel, Complement Pathway Panel]; appropriate for the initial evaluation of C3G patients, i.e. DDD or C3GN) | 07C3GFP | 83516(X2), 83520, 86160 (x10), 86161(x5), 86162, 86334 | $4500 | 4 weeks |
| Complement Antibody Micro-Panel (6 tests - FB autoantibody, FH autoantibody, Nef Activity Assay (IFE), C3Nef (C3CSA), C4Nef, C5Nef (C3CSAP); appropriate for following antibody levels) |
01AMP | 83516 (x2), 86161(x3), 86334 | $1812 | 4 weeks |
| Complement Biomarker Micro-Panel (11 tests - soluble C5b-9, FB, FH, FI, Ba, Bb, C3, C3c, C4, C5 and Properdin Levels; appropriate for following biomarker levels) |
02CBMP | 83520, 86160 (x10) | $2605 | 4 weeks |
| Complement Pathway Micro-Panel (3 tests - Hemolytic Assay, APFA, CH50eq; appropriate for following complement activity and complement blockade) |
01CPMP | 86161 (x2), 86162 | $691 | 4 weeks |
| Functional Tests - a la carte - Serum (1 ml frozen) | Test Codes | CPT Codes | Cost | TAT |
| CH50eq | 06CH50 | 86161 | $119 | 2 weeks |
| Alternative Pathway Functional Assay (APFA) | 06APFA | 86161 | $220 | 2 weeks |
| Hemolytic Assay | 06HA | 86162 | $352 | 4 weeks |
| C3b Deposition Assay | 01C3BDA | 86162 | $300 | 4 weeks |
| FB Autoantibody Testing | 06FBAA | 83516 | $356 | 4 weeks |
| FH Autoantibody Testing | 06FHAA | 83516 | $356 | 2 weeks |
| Nef Activity Assay (IFE) | 06NAA | 86334 | $200 | 4 weeks |
| C3Nef (C3CSA) | 06C3NEF | 86161 | $250 | 4 weeks |
| C5Nef (C3CSAP) | 06C5NEF | 86161 | $250 | 4 weeks |
| C4Nef | 06C4NEF | 86161 | $400 | 4 weeks |
| Biomarker Tests - a la carte - EDTA Plasma (1 ml frozen) | Test Codes | CPT Codes | Cost | TAT |
| C3 Level | 06C3L | 86160 | $110 | 2 weeks |
| C3c Level | 06C3CL | 86160 | $358 | 4 weeks |
| C4 Level | 06C4L | 86160 | $110 | 2 weeks |
| Factor B Level (FB) | 06FBL | 86160 | $165 | 2 weeks |
| Ba Level | 06BAL | 86160 | $275 | 2 weeks |
| Bb Level | 06BBL | 86160 | $275 | 2 weeks |
| Properdin Level | 06PL | 86160 | $330 | 2 weeks |
| C5 Level | 06C5L | 86160 | $300 | 2 weeks |
| Soluble C5b-9 (sMAC) | 06SMAC | 83520 | $352 | 2 weeks |
| Factor H Level (FH) | 06FHL | 86160 | $165 | 2 weeks |
| Factor I Level (FI) | 06FIL | 86160 | $165 | 2 weeks |
| ADAMTS-13 Assays - Citrated Plasma (1 ml frozen) | Test Codes | CPT Codes | Cost | TAT |
| ADAMTS-13 Activity Assay | 01ATS13 | 85397 | $400 | 24 hours |
| ADAMTS-13 Activity Assay w/ reflex to ADAMTS-13 Inhibitor Assay if activity <25% | 01ATS13RFX | 85397, 85335 | $800 | 24 hours |
Prices & tests offered subject to change on an quarterly basis. Effective 1/3/2020