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This document serves as a requisition for the Microsatellite Instability (MSI) test, including sections for patient and client information, billing details, and specimen information.
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How to fill out microsatellite instability test requisition
How to fill out Microsatellite Instability Test Requisition
01
Provide patient information: Enter the patient's full name, date of birth, and contact information.
02
Indicate the health insurance details: Include the insurance provider and policy number if applicable.
03
Specify the clinical indication: Write down the reason for testing, such as suspected Lynch syndrome or other hereditary cancer syndromes.
04
Select the specimen type: Mark whether the tissue sample is fresh, frozen, or paraffin-embedded.
05
Fill out the physician information: Include the referring physician's name, contact information, and any relevant credentials.
06
Check for any additional information required: Follow any specific instructions from the laboratory regarding extra documentation or sample handling.
07
Sign and date the requisition form: Ensure the form is signed by the authorized physician and includes the date of the request.
Who needs Microsatellite Instability Test Requisition?
01
Patients with a family history of Lynch syndrome.
02
Individuals diagnosed with colorectal cancer under the age of 50.
03
Patients with tumors exhibiting features suggestive of microsatellite instability.
04
Individuals requiring genetic counseling related to hereditary cancer syndromes.
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People Also Ask about
Is microsatellite instability good or bad?
There are several methods that can be used to detect microsatellite instability (MSI) or deficient DNA mismatch repair (dMMR). The two most common methods are polymerase chain reaction (PCR) and immunohistochemistry (IHC). MSI testing by PCR is the accepted gold standard method for MSI detection(1).
How much does the multi cancer early detection test cost?
Microsatellite instability testing is used to identify tumors caused by defective MMR by comparing the number of nucleotide repeats in a panel of microsatellite markers in normal tissue with the number from tumor tissue from the same individual.
What is the test for microsatellite instability?
MSI testing is performed on samples from a patient's tumor. It's generally based on five microsatellite markers. This type of testing may determine whether a tumor has high MSI, low MSI or is stable. High (MSI-H): Tumors have a high MSI if at least two of the five markers show instability.
What does the MSI test detect?
If you are eligible for MyRisk, there may be additional out of pocket costs. However, 95% of private insurance companies cover hereditary cancer testing. Overall, 90% of patients pay $0 out of pocket.
How much does the MSI test cost?
The cost of the MSI PCR test in India is INR 16,000.
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What is Microsatellite Instability Test Requisition?
The Microsatellite Instability Test Requisition is a formal request form used by healthcare providers to request testing for microsatellite instability, which is a condition associated with certain types of cancer, particularly colorectal cancer.
Who is required to file Microsatellite Instability Test Requisition?
Healthcare professionals, including doctors and oncologists, are required to file the Microsatellite Instability Test Requisition when they suspect a patient may have cancer associated with microsatellite instability.
How to fill out Microsatellite Instability Test Requisition?
To fill out the Microsatellite Instability Test Requisition, the healthcare provider must provide patient information, clinical details, request reason, and confirm consent, along with any necessary documentation or specimens for testing.
What is the purpose of Microsatellite Instability Test Requisition?
The purpose of the Microsatellite Instability Test Requisition is to facilitate testing for microsatellite instability, aiding in diagnosis, prognosis, and treatment decisions for certain cancers.
What information must be reported on Microsatellite Instability Test Requisition?
Information that must be reported includes patient demographics, clinical history, specific tests requested, physician details, and any relevant laboratory requirements.
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