PDF iconMORL 2017 Testing Menu (Effective beginning January 3, 2017)

Hearing Genetic Testing CPT Codes Cost TAT
OtoSCOPE® panel 81430, 81431 $1650 3 months
Usher panel:  USH1 genes: MYO7A, USH1C, CDH23, PCDH15USHIG, CIB2; USH2 genes: USH2A, GPR98, WHRN (DFNB31); USH3 genes: CLRN) 81404(x2), 81407(x3), 81408(x2), 81479(x3) $1650 3 months
GJB2/GJB6 (Connexin 26/30) 81252 / 81254 $356 8 weeks
GJB2/GJB6 (Connexin 26/30) familial 81253 $220 8 weeks
MTRNR1- C1494T and A1555G mutations 81401 – MTRNR1 $185 8 weeks
MTTL1-A3243G mutation 81401 – MTTL1 $185 8 weeks
MTTS1-A7445G mutation 81401 – MTTS1 $185 8 weeks
OtoSCOPE Familial Mutation Testing (cost is per person/per gene) 81403 $220 8 weeks
Kidney Genetic Testing CPT Codes Cost TAT
Genetic Renal Panel v5.0 (appropriate for patients with TMA, TTP, aHUS, DDD and C3GN) - genes included: CFH, CFI, MCP, CFB, CFHR5, C3, THBD, ADAMTS13, PLG, DGKE, MMACHC, and MLPA 81479, 81405 $3000 28 days
MLPA (screening for deletions of CFHR1-CFHR3) 81405 $686 8-12 weeks
Familial Mutation Testing 81403 $220 2 weeks
Functional/Biomarker Tests - Panels CPT Codes Cost TAT
TMA Functional Panel (11 tests - FH autoantibody, Hemolytic Assay, CH50APFA, Bb, FH, FI, FB, C3, C4, & sC5b-9.  Note: ADAMTS-13 activity is available 'a la carte') 83516, 83520, 85397, 86160(x5), 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) 83516(x2), 83520, 86160(x7), 86161(x5), 86162, 86235(x3), 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) 83516(x2), 86160(x3), 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) 83516, 83520, 86160(x10) $2605 4 weeks
Complement Pathway Micro-Panel (3 tests - Hemolytic Assay, APFA, CH50; appropriate for following complement activity and complement blockade) 86161(x2), 86162 $691 4 weeks
Functional Tests - a la carte - Serum (1 ml frozen) CPT Codes Cost TAT
CH50 86162 $119 2 weeks
Alternative Pathway Functional Assay (APFA) 86161 $220 2 weeks
Hemolytic Assay 86161 $352 4 weeks
FB Autoantibody Testing 83516 $356 4 weeks
FH Autoantibody Testing 83516 $356 2 weeks
Nef Activity Assay (IFE) 86334 $200 4 weeks
C3Nef (C3CSA) 86235, 86161 $200 4 weeks
C5Nef (C3CSAP) 86235, 86161 $250 4 weeks
C4Nef 86235, 86161 $400 4 weeks
Biomarker Tests - a la carte - EDTA Plasma (1 ml frozen) CPT Codes Cost TAT
C3 Level 86160 $110 2 weeks
C3c Level 86160 $358 4 weeks
C4 Level 86160 $110 2 weeks
Factor B Level (FB) 86160 $165 2 weeks
Ba Level 86160 $275 2 weeks
Bb Level 86160 $275 2 weeks
Properdin Level 86160 $330 2 weeks
C5 Level 86160 $300 2 weeks
Soluble C5b-9 (sMAC) 83520 $352 2 weeks
Factor H Level (FH) 86160 $165 2 weeks
Factor I Level (FI) 86160 $165 2 weeks
ADAMTS-13 Assays - Citrated Plasma (1 ml frozen) CPT Codes Cost TAT
ADAMTS-13 Activity Assay 85397 $400 24 hours
ADAMTS-13 Inhibitor Assay 85397, 85335 $400 24 hours
ADAMTS-13 Activity with Inhibitor Assay 85397, 85335 $550 24 hours

 

Prices & tests offered subject to change on an quarterly basis. Effective 1/3/2017