Sign in →

Test Code MISC6MYRIADBRAC BRACAnalysis Comprehensive (BRCA1 & BRCA2)

Important Note

Must have collection kit and paperwork from Myriad prior to draw.

Department

SEND OUTS

Reference Lab Test Number

BRAC

Collection Requirements

-Must have collection kit and paperwork from Myriad prior to draw.

-Complete the Test Request Form. Complete the Patient Authorization Form for insurance and /or patient payment.

-Draw one tube of blood using 10 mL purple top (EDTA) tube.

-Write the patient’s name and/or ID number and specimen collection date on the bar code label found on the upper right-hand corner of the Test Request Form. Peel off the label and place lengthwise on the sample tube.

-Do Not centrifuge, refrigerate, or freeze sample.

Primary Collection Container

Collection kit

Transport

Put the Specimen Collection and Transportation Kit into the Federal Express (FedEx) Mailer.

Affix the prepaid airbill to the outside of the FedEx mailer.

Keep the FedEx Customer Receipt for your reference.

Processing

Put the blood tube into the foam-lined box and seal box in the small plastic biohazard bag.

Place the following items in the Specimen Collection and Transportation Kit:

1.Patient sample

2.Completed Test Request Form

3.Completed Patient Authorization Form

4.Photocopies of patient’s insurance card

5.For Medicare patients, completed Advance Beneficiary Notice and letter of medical necessity.

6.Completed itemized list of contents

Stability

5 days

Unacceptable Conditions

Centrifuged, refrigerated or frozen samples. Specimens greater than 72 hours old.

Additional Information

Covenant HealthCare does not incur any costs related to this test. Covenant HealthCare is only acting as a drawing facility for the test. The patient is responsible for all costs. A Patient Authorization Form must be filled out. Under test payment options, option 1 should be checked. Under option 1 no work is performed until an insurance verification check is performed by Myriad Laboratory. Myriad will notify the patient of their financial resposibility and give them option to cancel the test. There are 2 pages to the form, make sure that both sides are filled out. The patient must sign the form. If the patient’s insurance is Medicare, the patient must fill out and sign the ABN that is in the kit in addition to the Patient Authorization Form.

Only collect Monday – Thursday before 2:00 pm. Specimen must arrive in send outs prior to 4:00 pm.

Test prices:

1.Comprehensive BRACAnalysis = $3,340.00

2.BRCA1 Analysis = $1,750.00

3.BRCA2 Analysis = $2,090.00

Myriad Customer Service (800)469-7423