Out of Center Genetic Testing – Requisition and Funding Application - (B)

Test Code: MD

Alternate Name(s): Referred Out Genetic Testing

Description: Clinicians may request molecular genetic testing that is not available within Shared Health Molecular Diagnostic Laboratory  (A190-20-0106A V03 Appendix A - MDL In-House Test Menu) 

Physicians should identify referral laboratory and test code. Final selection will be at the discretion of the Molecular Diagnostic Laboratory as referral laboratories are evaluated and monitored to ensure quality metrics are met.
Requesting physicians are to collect the patient specimen using the “Molecular Diagnostic Laboratory – Out of Centre Genetic Test Requisition”. The genetic test being requested must be for the purpose of diagnosis, prevention, familial variant testing, and/or treatment.

Each test request will be evaluated regarding availability of the genetic test requested and whether patient meets appropriate criteria for testing.  Requests approved may be limited by the “referred-out budget”.

Urgent requests must be identified on the requisition itself. Common reasons are molecular results would impact urgent medical management OR management of an affected or at-risk pregnancy.

It is the ordering physician’s responsibility to provide all relevant patient and family information on the requisition to ensure accurate testing. It is also the physician’s responsibility to obtain and document informed consent.

The physician will be informed when the test request has been approved.  For requests not approved, the physician will be notified that testing will not be pursued and reason(s) will be shared.  Please provide a PHIA compliant fax number or e-mail for this communication.
 
For prenatal diagnosis, contact laboratory for prior approval and to obtain specimen requirements.

Test Indications: Dependent on genetic test being ordered.

Test Approval Requirements: Contact Lab Genetic Counsellor at GenomicsLabGC@sharedhealthmb.ca or ph: 204-787-4033 with any questions. Requests will be reviewed and approved by either a Molecular Geneticist or a committee of physicians with expertise in genetic and genomic conditions.

 

Keep specimen at room temperature.  Microtainer(s) for infants only.

_SH Molecular Diagnostic Laboratory Out of Centre Genetic Test Requisition (R250-10-103)

Reference Intervals: An interpretive report from the referral laboratory will be forwarded to the ordering physician.

Within 6 Months

Extracted DNA or whole blood is forwarded to an out-of-province laboratory for testing, if test request is approved. Turnaround time is estimated to be 8 to 12 weeks from the date of sample shipping. Date of approval is not necessarily the date of shipping. Expedited turnaround time, where medically indicated, available upon request.