Cytogenetic Test Request Form Recommended (ARUP form #43098)

Ordering Recommendation

Use to detect copy number alterations and loss of heterozygosity in FFPE specimens from products of conception.

New York DOH Approval Status

Testing is not New York state approved. Specimens from New York clients will be sent out to a New York state-approved laboratory.

Specimen Required

Patient Preparation

Fetal autopsy or products of conception.

Specimen Preparation

FFPE Fetal tissue: Transport ten slides, each with 5 µm unstained sections or four 20 µm scrolls or tissue block.
OR FFPE villi: Transport one H&E stained slide and ten slides, each with 5 µm unstained sections or tissue block.
New York State Clients: Transport 1 FFPE block or 10 slides (10 µm each).

Storage/Transport Temperature

Room temperature. Also acceptable: Refrigerated. Ship in cooled container during summer months.

Unacceptable Conditions

Specimens fixed or processed in alternative fixatives or heavy metal fixatives (B-4 or B-5).


If multiple specimens (blocks or slides) are sent to ARUP, they must be accompanied by one of the following: an order comment indicating that the ARUP pathologist should choose the specimen most appropriate for testing (e.g., "Choose best block"), or individual orders for each sample submitted. A Pathologist Block Selection Fee (ARUP test code 3002076) will be added to orders that utilize the first option. If multiple specimens are sent to ARUP without a request for pathologist block/slide selection or individual orders, they will be held until clarification is provided.


Ambient: Indefinitely; Refrigerated: Indefinitely; Frozen: Unacceptable


Molecular Inversion Probe Array




14-21 days

Reference Interval

Interpretive Data

For detection of copy number alterations and loss of heterozygosity in FFPE specimens.
Refer to report.

This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.

Counseling and informed consent are recommended for genetic testing. Consent forms are available online.

Compliance Category

Laboratory Developed Test (LDT)


If sending placenta instead of fetal tissue, at least 80% villi for products of conception specimens.

This test must be ordered using Cytogenetic test request form #43098 or through your ARUP interface. Please submit the Patient History for Prenatal Cytogenetics form with the electronic packing list (https://ltd.aruplab.com/Tests/Pdf/65).

Hotline History


CPT Codes



Component Test Code* Component Chart Name LOINC
2002148 Block ID 57723-9
2010796 Cytogenomic MIP Array FFPE, POC
2010877 EER Cytogenomic MIP Array FFPE, POC 11526-1
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.


  • 45,X
  • 45X
  • aCGH
  • anomalies
  • array CGH
  • Array Comparative Genomic Hybridization
  • birth defects
  • CGH
  • Chromosomal Microarray
  • CMA
  • Down
  • Down syndrome
  • Edward
  • Edward syndrome
  • MCA
  • Microarray
  • microdeletion
  • microduplication
  • miscarriage
  • monosomy
  • multiple congenital anomalies
  • Patau
  • Patau syndrome
  • product of conception, POC, villi, placenta, fetal loss, fetal demise, abortion, pregnancy loss, sti
  • SAB
  • Single-nucleotide-polymorphism (SNP) array
  • T13
  • T18
  • T21
  • tissue
  • trisomy 13
  • Trisomy 18
  • Trisomy 21
  • Turner; Turner syndrome
  • Whole Genome Array, formalin-fixed, paraffin-embedded, FFPE
  • XO
Cytogenomic Molecular Inversion Probe Array FFPE Tissue - Products of Conception