Test Id : HPWET
Hematopathology Consultation, MCL Embed
Useful For
Suggests clinical disorders or settings where the test may be helpful
Obtaining a rapid, expert opinion for diagnosis of hematologic and non-hematologic diseases using unprocessed bone marrow biopsy specimens referred by the primary pathologist
Obtaining special studies that are not available locally
Highlights
Our consultative practice strives to provide the highest quality diagnostic consultative service, balancing optimal patient care with a cost-conscious approach that supports the rapid turnaround time for diagnostic results.
If a bone marrow pathology consultation is requested, the Mayo Clinic hematopathologists approach the diagnosis in the same way as Mayo Clinic's in-house cases.
Reflex Tests
Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.
| Test Id | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| BMAPC | Bone Marrow Aspirate | No, (Bill Only) | No |
| BMBPC | Bone Marrow Biopsy | No, (Bill Only) | No |
| BMCPC | Bone Marrow Clot | No, (Bill Only) | No |
| DCALP | Decalcification | No, (Bill Only) | No |
| PBPC | Peripheral Blood | No, (Bill Only) | No |
| PBTC | Peripheral Blood, TC | No, (Bill Only) | No |
| PPPC | Particle Prep | No, (Bill Only) | No |
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
Laboratory approval is required prior to ordering this test. Contact Mayo Clinic Laboratories at 800-533-1710.
A Mayo Clinic hematopathologist will provide a full bone marrow workup that includes an evaluation of the specimen and determination of a diagnosis provided within a formal pathology report.
Ancillary Testing:
Based on Mayo Clinic-approved algorithms or at a staff hematopathologist's discretion, ancillary testing may be performed to assist in rendering an accurate diagnosis and provide important prognostic information. These test results (eg, cytochemical stains on bone marrow aspirate smear, immunohistochemical stains on bone marrow biopsy or clot sections, chromosome analysis, fluorescence in situ hybridization, flow cytometry, microarray, molecular and/or next-generation sequencing testing) will be reported and billed separately. While reported separately, these results will continue to be considered and referred to in the final pathology interpretation.
If ancillary testing (eg, flow cytometry) is desired by the client outside of this consultation, each test must be ordered separately. Tests ordered outside of the consultation may or may not be integrated into the final pathology report based on the staff hematopathologist's discretion.
If the volume of bone marrow aspirate is limited, prioritization of testing will be determined by the staff hematopathologist. Testing requested or suggested by the referring physician (immunostains, molecular studies, etc) may not be performed if deemed unnecessary by the reviewing staff hematopathologist.
Note: Calls are not routinely made; however, depending on the nature of the case, a call may be placed to the ordering provider or pathologist. These situations include, but are not limited to, a new diagnosis of acute leukemia or aggressive high-grade lymphoma. To contact a Mayo Clinic hematopathologist, call the Hematopathology Communications team at 507-284-5600.
For more information see:
Method Name
A short description of the method used to perform the test
Medical Interpretation
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
Acute leukemia consultation
Acute lymphocytic leukemia-differentiate T from non-T cell forms
Bone Marrow Consultation
Cytochemical
Hematology Consultation
HPWET
PATHC
Pathology Consultation
Surgical Pathology Consultation, Slides or Blocks
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
Laboratory approval is required prior to ordering this test. Contact Mayo Clinic Laboratories at 800-533-1710.
A Mayo Clinic hematopathologist will provide a full bone marrow workup that includes an evaluation of the specimen and determination of a diagnosis provided within a formal pathology report.
Ancillary Testing:
Based on Mayo Clinic-approved algorithms or at a staff hematopathologist's discretion, ancillary testing may be performed to assist in rendering an accurate diagnosis and provide important prognostic information. These test results (eg, cytochemical stains on bone marrow aspirate smear, immunohistochemical stains on bone marrow biopsy or clot sections, chromosome analysis, fluorescence in situ hybridization, flow cytometry, microarray, molecular and/or next-generation sequencing testing) will be reported and billed separately. While reported separately, these results will continue to be considered and referred to in the final pathology interpretation.
If ancillary testing (eg, flow cytometry) is desired by the client outside of this consultation, each test must be ordered separately. Tests ordered outside of the consultation may or may not be integrated into the final pathology report based on the staff hematopathologist's discretion.
If the volume of bone marrow aspirate is limited, prioritization of testing will be determined by the staff hematopathologist. Testing requested or suggested by the referring physician (immunostains, molecular studies, etc) may not be performed if deemed unnecessary by the reviewing staff hematopathologist.
Note: Calls are not routinely made; however, depending on the nature of the case, a call may be placed to the ordering provider or pathologist. These situations include, but are not limited to, a new diagnosis of acute leukemia or aggressive high-grade lymphoma. To contact a Mayo Clinic hematopathologist, call the Hematopathology Communications team at 507-284-5600.
For more information see:
Specimen Type
Describes the specimen type validated for testing
Varies
Ordering Guidance
1. If requesting a peripheral blood smear evaluation only, order SPSM / Morphology Evaluation (Special Smear), Blood.
2. If requesting a hematopathology consultation on paraffin-embedded tissue and slides, order PATHC / Pathology Consultation. Also include a cover letter indicating hematopathology review requested.
3. If requesting a hematopathology consultation and only paraffin-embedded biopsy/clot samples and bone marrow aspirate are submitted, order HPCUT / Hematopathology Consultation, Client Embed. Orders for HPCUT require MCL prior authorization.
Shipping Instructions
Attach the green "Attention Pathology" address label (T498) to the outside of the transport container before putting into the courier mailer.
Necessary Information
All requisition and supporting information must be submitted in English.
Each of the following items is required:
1. All requisitions must be labeled with:
-Patient name, date of birth, medical record number, and either case number or pathology ID
-Name and phone number of the referring pathologist or ordering provider
-Collection date
2. Hematopathology Patient Information (T676); print and submit with the case
3. A recent Hematology/Oncology clinical note; print and submit with the case
4. Complete blood cell count (CBC) results from testing performed within 14 days of bone marrow collection.
5. Indicate clinical reason/context
6. All pending and final reports for ancillary testing on submitted specimens.
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
All specimens are required to perform testing.
Supplies: Bone Marrow Collection Kit (T793)
Additional Information:
All specimens and paperwork must be labeled with:
-Two patient identifiers (patient name, date of birth, medical record number, case number, or pathology ID)
-Specimen type
Information on collecting, packaging, and shipping specimens is available:
-Bone Marrow Core Biopsy, Clot, and Aspirate Collection Guideline
-Assistance with Bone Marrow Collection
Specimen Type: Bone marrow aspirate
Slides: 5
Preferred: Freshly prepared slides made at the time of specimen collection
Acceptable: Slides made from EDTA bone marrow specimen, within 2 hours of collection
Submission Container/Tube: Plastic slide holder
Specimen Volume: 5 Total slides: 2 direct smears and 3 unit prep slides; unfixed and unstained, per unilateral collection
Collection Instructions:
1. Prepare slides of bone marrow aspirate.
2. If bone marrow units are sparse or absent or aspirate is a dry tap, make biopsy touch prep slides.
3. Air dry slides. Do not place on hot plate to dry.
4. Place Parafilm around the slide carriers holding unstained slides to prevent exposure to formalin fumes during transport. Place slides in a separate bag apart from any formalin-fixed clot or core biopsy specimens. If using slide carriers, make sure they have not been used to carry fixed slides previously.
Specimen Type: Bone marrow aspirate
Container/Tube: Lavender top (EDTA) and yellow top (ACD solution A or B)
Specimen Volume: 2 x 3 mL in EDTA and 2 x 6 mL in ACD solution A or B
Collection Instructions:
1. Aspirate per standard bone marrow collection procedure.
2. Send bone marrow specimens in original tubes. Do not aliquot.
Specimen Type: Bone marrow aspirate clot
Container/Tube: Bone marrow aspirate clot in 10% formalin
Specimen Volume: 0.5 mL
Collection Instructions:
1. Place 0.5 mL bone marrow aspirate in clot tube.
2. After clot has formed, place clot in 10% formalin.
3. Place Parafilm around the container to prevent exposure.
Specimen Type: Bone marrow core biopsy
Container/Tube: Fixed biopsy core in 10% formalin
Collection Instructions:
1. If bone marrow units are sparse or absent, or aspirate is a dry tap, make biopsy touch prep slides.
2. Place biopsy core in 10% formalin immediately after collection.
3. Fix in 10% formalin for 1 to 2 hours.
4. Place Parafilm around the 10% formalin container to prevent exposure.
Specimen Type: Blood
Slides: 2
Preferred: 2 Freshly prepared fingerstick slides
Acceptable: 2 Slides made from whole blood in EDTA, within 8 hours of collection
Submission Container/Tube: Plastic slide holder
Specimen Volume: 2 Unstained and unfixed slides
Collection Instructions:
1. Prepare 2 smears of even thickness.
2. Place Parafilm around the slide carriers holding unstained slides to prevent exposure to formalin fumes during transport. Place slides in a separate bag apart from any formalin-fixed clot or core biopsy specimens. If using slide carriers, make sure they have not been used to carry fixed slides previously.
Special Instructions
Library of PDFs including pertinent information and forms related to the test
Forms
1. Hematopathology Patient Information (T676) is required.
2. If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-Hematopathology/Cytogenetics Test Request (T726)
-Benign Hematology Test Request (T755)
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
See Specimen Required
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Ambient | ||
Useful For
Suggests clinical disorders or settings where the test may be helpful
Obtaining a rapid, expert opinion for diagnosis of hematologic and non-hematologic diseases using unprocessed bone marrow biopsy specimens referred by the primary pathologist
Obtaining special studies that are not available locally
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
Laboratory approval is required prior to ordering this test. Contact Mayo Clinic Laboratories at 800-533-1710.
A Mayo Clinic hematopathologist will provide a full bone marrow workup that includes an evaluation of the specimen and determination of a diagnosis provided within a formal pathology report.
Ancillary Testing:
Based on Mayo Clinic-approved algorithms or at a staff hematopathologist's discretion, ancillary testing may be performed to assist in rendering an accurate diagnosis and provide important prognostic information. These test results (eg, cytochemical stains on bone marrow aspirate smear, immunohistochemical stains on bone marrow biopsy or clot sections, chromosome analysis, fluorescence in situ hybridization, flow cytometry, microarray, molecular and/or next-generation sequencing testing) will be reported and billed separately. While reported separately, these results will continue to be considered and referred to in the final pathology interpretation.
If ancillary testing (eg, flow cytometry) is desired by the client outside of this consultation, each test must be ordered separately. Tests ordered outside of the consultation may or may not be integrated into the final pathology report based on the staff hematopathologist's discretion.
If the volume of bone marrow aspirate is limited, prioritization of testing will be determined by the staff hematopathologist. Testing requested or suggested by the referring physician (immunostains, molecular studies, etc) may not be performed if deemed unnecessary by the reviewing staff hematopathologist.
Note: Calls are not routinely made; however, depending on the nature of the case, a call may be placed to the ordering provider or pathologist. These situations include, but are not limited to, a new diagnosis of acute leukemia or aggressive high-grade lymphoma. To contact a Mayo Clinic hematopathologist, call the Hematopathology Communications team at 507-284-5600.
For more information see:
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Diagnosis of a hematologic disease requires thorough and accurate morphologic examination of peripheral blood and bone marrow as well as interpretation of ancillary testing results (eg, cytochemistry, immunohistochemistry, flow cytometric immunophenotyping, chromosome analysis, and fluorescence in situ hybridization and molecular testing) by a highly qualified hematopathologist. With recent advent of new understanding and treatment options, more ancillary tests are available. Efficient utilization and accurate interpretation of these tests are crucial for patient care. These tests can assist in rendering an accurate diagnosis and could provide prognostic prediction and potential indication or guidance of therapy.
Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
An interpretive report will be provided.
Interpretation
Provides information to assist in interpretation of the test results
Results of the consultation are reported in a formal pathology report that includes a description of ancillary test results (if applicable) and an interpretive comment. When the case is completed, results may be communicated by a phone call.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
All appropriate stained/unstained slides, biopsy tissue, and aspirate are required to make a diagnosis. The referring pathologist's and clinician's name and phone numbers are essential. Specific diagnosis may require correlation with clinical information; this information must be sent with the specimen.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
Sundaram S, Jizzini M, Lamonica D, et al. Utility of bone marrow aspirate and biopsy in staging of patients with T-cell lymphoma in the PET-Era-tissue remains the issue. Leuk Lymphoma. 2020;61(13)3226-3233. doi:10.1080/10428194.2020.1798950
Method Description
Describes how the test is performed and provides a method-specific reference
All requests will be processed as a consultation case. Ancillary testing will be performed as appropriate to be diagnostically indicated and at an additional charge.
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Monday through Saturday
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
- Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
Not Applicable
CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
85007 (if appropriate)
85060 (if appropriate)
85097 (if appropriate)
88305 (if appropriate)
88311 (if appropriate)
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| HPWET | Hematopathology Consult | 78251-6 |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| 71098 | Interpretation | 60570-9 |
| 71099 | Participated in the Interpretation | No LOINC Needed |
| 71100 | Report electronically signed by | 19139-5 |
| 71101 | Addendum | 35265-8 |
| 71102 | Gross Description | 22634-0 |
| 71446 | Material Received | 85298-8 |
| 71103 | Disclaimer | 62364-5 |
| 71827 | Case Number | 80398-1 |