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Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of at least 12 genes, including BRAF, CBL, HRAS, KRAS, MA

CPT4 code

Name of the Procedure:

Genomic Sequence Analysis Panel for Noonan Spectrum Disorders
Common name: Genetic Testing for Noonan Spectrum Disorders

Summary

This procedure uses advanced genomic sequencing to analyze multiple genes associated with Noonan spectrum disorders, including Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, and Noonan-like syndrome. The test includes sequencing at least 12 specific genes, such as BRAF, CBL, HRAS, KRAS, and MA.

Purpose

The genomic sequence analysis panel aims to diagnose and understand the genetic causes of Noonan spectrum disorders. By identifying specific gene mutations, healthcare providers can offer targeted treatments, inform families about prognosis, and provide appropriate genetic counseling.

Indications

This procedure is indicated for patients exhibiting symptoms such as:

  • Distinctive facial features
  • Heart defects
  • Growth delays
  • Learning difficulties
  • Skin abnormalities
  • Skeletal malformations

Additionally, patients with a family history of Noonan spectrum disorders or related genetic conditions may be candidates for this testing.

Preparation

There is minimal preparation required for genomic sequencing:

  • No fasting needed.
  • Patients should provide a detailed family history and medical records.
  • Blood sample or saliva collection may be needed, which requires no special preparation.

Procedure Description

  1. Sample Collection: A blood or saliva sample is collected from the patient.
  2. DNA Extraction: DNA is extracted from the sample in a laboratory.
  3. Sequencing: Using next-generation sequencing technology, the DNA is analyzed to identify mutations in at least 12 genes known to be associated with Noonan spectrum disorders.
  4. Data Analysis: Bioinformatics tools are used to interpret the sequencing data and identify significant genetic variations.
  5. Results: The results are reviewed by a geneticist who provides a report with findings and recommendations.

Duration

The sample collection takes about 15-30 minutes. The sequencing and analysis can take several weeks, typically 4-8 weeks.

Setting

Sample collection can be done in a hospital, outpatient clinic, or at home with a provided kit. Sequencing and analysis are performed in a specialized laboratory.

Personnel

  • Geneticist
  • Laboratory Technician
  • Nurse or Phlebotomist (for sample collection)

Risks and Complications

  • Minimal physical risk from sample collection (e.g., slight pain or bruising from blood draw).
  • Psychological or emotional impact due to genetic findings.

Benefits

  • Accurate diagnosis of Noonan spectrum disorders.
  • Customized treatment plans based on genetic information.
  • Informed genetic counseling for the patient and family.

Recovery

There are no significant recovery steps as the procedure involves only sample collection. Normal activities can be resumed immediately after.

Alternatives

  • Clinical Genetic Evaluation: A detailed clinical examination without genomic sequencing.
  • Single-Gene Testing: Testing of individual genes based on clinical suspicion.
  • The alternatives might be less comprehensive and miss causative mutations present in multiple genes.

Patient Experience

  • During Sample Collection: Patients might feel mild discomfort during a blood draw or none if using a saliva kit.
  • After Sample Collection: No immediate post-procedure symptoms. Anticipation while awaiting results can cause anxiety.
  • Genetic Counseling: Supportive services will aid in understanding and coping with the findings.

Pain management is generally not required, as the procedure is non-invasive beyond the sample collection stage.

Medical Policies and Guidelines for Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of at least 12 genes, including BRAF, CBL, HRAS, KRAS, MA

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