Genetic Screening

For NIPT (cell free DNA):

Myriad's test is called Prequel.   It can be ordered anytime from 10 weeks of gestation and later. 

1.  order the test
   A number of possible tests within Prequel can be ordered.  To simplify things, we are recommending that you place two orders in your preference list:

522043 - Myriad Prequel Chromosomes 13, 18, 21

522049 - Myriad Prequel Chromosomes 13, 18, 21 + Sex Chromosome Analysis

if the patient is interested in fetal gender, you MUST order 522049.  If they do NOT want to know the gender, either you order 522043 or you tell them not to look in MyChart at their results.  The drawback to ordering only 522043 is that other sex chromosomal abnormalities (XXY, XYY, Monosomy X) will not be identified.   There are additional tests that can be added based on history or known fetal abnormalities.  More on this later. 

2.  Fill out the required RED sections of the order (this will replace the paper you previously sent to the lab with the patient). You no longer need to use the paper forms - hooray!

3.  Give patient the test box.  These will be found in the Red Team pod in the upper middle cabinet.  There is one for Prequel, one for Foresight and one box containing both Prequel and Foresight.  If the patient is getting both tests, give them a combo box.  If they are only getting one of the tests, give the individual box.  If no individual boxes are available it is OK to give a double box (and vice versa).

4.  Instruct patient to go downstairs to the lab WITH the box for a blood draw.  Please encourage them to go immediately after appointment.  The lab will NOT be stocking the boxes so if a patient forgets it at home they won't be able to get the test done.

5.  Await result. All results will result in Epic.  Please call patient with result and document. 

For Carrier Screening:

Myriad's test is called Foresight. This can be done anytime during pregnancy or when not pregnant. This should not be repeated in future pregnancies

1.  Order the test

Within Foresight, numerous tests can be ordered.  We recommend that you put the following order in your preference list: 

522039 - Myriad Foresight Fundamental Plus Panel, Fundamental Panel with Fragile X (14 conditions)

This version of Foresight tests for only 14 things.  This is the ACOG recommended screening.  This will significantly cut down on the number of positive tests we receive. 😅  

2.  Fill out the required RED areas of the order (this replaces the paper; you no longer need to send the paper)

3.  Give patient the box (Located in Red Team Pod in the upper middle cabinet).  If the patient is getting only Foresight drawn, give the individual box.  If no individual box is available, give the combo box. 

4. Send patient to the lab

5. Await results.   They will come directly to Epic.  If the patient is positive for one of the genes, offer genetic testing for the FOC using the below process.

For Partner (FOC) Carrier Screening:

If you have a patient who is interested in testing for the FOC, please contact our RNs. They will give you a form for the patient/FOC a form to complete (also available in the RN office under the BP logs), which must include a name, address, phone number, and email address for the FOC as well as the condition that MOC tested positive for. Completed forms should be returned to Lori for processing. Myriad will reach out to the FOC to ship them a collection kit. The FOC collects a saliva specimen and mails the kit back (prepaid via FedEx; there is even a Fed-Ex drop box outside of our clinic building if needed). Results of the testing will come to our RNs, who will then distribute the results to the ordering provider at Bruner. There should not be any cost for testing for the FOC, however, if there is, Myriad will contact the FOC prior to running the test.

We do have a limited number of saliva kits in the RN office if you have a FOC in office that you feel would benefit from being given a kit directly. You will still need to complete the paper form and return it to the RNs prior to giving a kit out. Please do not give out blood kits from the Red Team station for FOC testing.

Other Helpful Info:

We have our own genetic counselor for our region through Myriad, who is available to answer any questions about abnormal screening results. Her name is Andrea Pirages, phone 513-332-7935 or email andrea.pirages@myriad.com. She and one of the Myriad reps will be presenting at noon conference on Monday, December 18th to provide more information on their testing process and services.

Myriad will notify patients by phone number or email what the estimated cost of the tests will be prior to running any tests.  Medicaid and private insurance should cover all of these tests.   Our charity patients should be covered under the Myriad charity program. 

ACOG practice bulletin on counselling.

Myriad financial assistance form for uninsured patients