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36260: Pd-l1 Non-lung (pembrolizumab), Ihc Print View
Paraffin Block Number:      
Primary Tumor Site:      
Collection Site:      
Tumor Type:      
Stage:      
Recurrence:      
Grade:      
Oncologist Name:      
Oncologist NPI:      
Pathologist Name:      
Pathologist NPI:      
Quest Internal Number:      
PD-L1 Result      
Reporting Pathologist:      

PRIMARY
1 FFPE Tissue (Block/Slide) 1 (1) g   Room Temperature - 12 Month(s)/Refrigerated - 12 Month(s)  
ALTERNATE
  5 Unstained Charged(+) Sl   Refrigerated - 30 Day(s)/Room Temperature - 30 Day(s)  

PD-L1 IHC 22C3 pharmDx is indicated as an aid in identifying patients for treatment with KEYTRUDA(R) (Pembrolizumab). This FDA approved test currently is applicable only to adenocarcinomas of gastric or gastro-esophageal junction origin. For non-FDA approved test indications or sample types, order 94007-PD-L1, IHC. For other FDA approved primary tumors, please order the following: For NSCLC order 93279-PD-L1 Lung (Pembrolizumab), 93359-PD-L1 Lung (Nivolumab) or 94480-PD-L1 Lung (Atezolizumab); for urothelial bladder carcinoma order 94047-PD-L1 Bladder (Atezolizumab); and for melanoma order 93793-PD-L1 Melanoma (Nivolumab).

FFPE: State any other type of fixative used.
A pathology report which
includes the paraffin block number, and both macroscopic and
microscopic evaluation and diagnosis, should be sent with the
specimen.
Submit only specimens of gastric or gastro-esophageal junction
adenocarcinoma (primary or metastatic).
Setup Schedule
Sunday-Friday

Reported (Analytical Time)
3 days

CPT Code
88360

The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

Notes
Specimen Requirements:
Preferred: Formalin fixed paraffin embedded tissue collected in IHC specimen transport kit
Acceptable: 5 (5 micron) Unstained charged(+) slides collected in IHC specimen transport kit
Specimen Stability:
Tissue: Room temperature and Refrigerated: 5 years
Slides: Room temperature and Refrigerated: 30 days
All specimens: Frozen: Unacceptable
Reject Criteria: Tumor primary is other than gastric or gastro-esophageal junction adenocarcinoma. Baked or melted slides;previously stained slides; Cytospins; Cytology cell block; Decalcified specimens; Fixatives other than formalin.
Transport Temperature: Room temperature
Methodology: Immunohistochemical Stain






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