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23059 Surgical Pathology, Muscle Biopsy

Surgical Pathology, Muscle Biopsy
Test Code: HMISC
Synonyms/Keywords
Histology​
Useful For
A muscle biopsy can lead to the discovery of problems with the nervous system, connective tissue, vascular system, or musculoskeletal system. In humans with weakness and low muscle tone, a muscle biopsy can help distinguish between myopathy (where the pathology is in the muscle tissue itself) and neuropathy (where the pathology is at the nerves innervating those muscles), by microscopic analysis for differing characteristics when exposed to a variety of chemical reactions and stains.​
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​Skeletal Muscle Petri Dish or Other Specimen Container  - closed with or without a Muscle Clamp​ ​

​With clamp, as thick as possible - 2.5 cm in length by 0.5 cm in diamter minimum.  Does not have to be stretched thin. 

Without a clamp, it should meaure at least 1.0 x 0.5 cm minimum after removal, as the muscle contracts.

 ​ ​
Collection Processing Instructions

Histology must be notified 24 hours in advance 715-221-6175.

The muscle biopsy must be sent “fresh” in an enclosed container to prevent drying out with slightly moistened saline gauze wrapped around the specimen. Do not submerge the samples in saline as this will cause a swelling artifact. Also, do not let the sample dry out which will cause enzyme activity to be lost. The specimen must remain in a refrigerated state immediately after biopsy and throughout transportation.

Muscle biopsy specimens will be accepted only if the following conditions are met.
• Must be received within 24 hours.
• Muscle specimens are only accepted Monday through Friday between 8:00 am - 4:00 pm. No specimens are accepted on weekends or holidays.
• Specimen container must be labeled STAT and deliver to Histology immediately.

Send/Deliver to:
Marshfield Labs-Histology Department 701 West Kalsched Ave, Laird N 4th floor Marshfield, WI 54449

Required information to be sent with the muscle biopsy:
• Completely fill out a Histology requisition form. Please call (715) 221-6700 Marshfield Labs Customer Service at 800-222-8535 for a Histology Requisition form.
• Clinical history-- brief and detailed clinical information (results of electromyography skeletal MRI if available).

Any questions please call the Marshfield Histology Lab 715-221-6175. ​

Acceptable Body Sites
​Various per clinician.
Acceptable Specimen Types
​Skeletal Muscle
Specimen Stability Information
Specimen Type Temperature Time
​Fresh Muscle ​Room Temperature ​< 30 minutes after removal
​Fresh Muscle ​Refrigerated ​> 30 minutes after removal and < 24 hours
Interference
Improperly handled – placed in any type of fixative will void testing other than performing routine histology and possibly other paraffin stains per pathologist. Additionally, if specimen is > 24 hours when received, the specimen quality may be compromised.
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Marshfield ​Monday - Friday ​1 week ​Hematoxylin & Eosin, Histochemistry Stains,
Electron Microscopy, Immunohistochemistry, & Special Stains
Test Information

This test should be regarded as 'Research Use Only'. This test has not been cleared or approved by the U.S. Food and Drug Administration. It may not be covered by insurance and providers need to inform all patients of this prior to ordering. 

For Medicare patients, an Advanced Beneficiary notice (ABN) is required; for Medicaid patients, a Noncovered Services Waiver is required, and for commercial payers, prior authorization should be obtained.   ​

​​

Reference Range Information
Performing Location Reference Range
​Marshfield ​Interpretive Report
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
88305 ​ ​1 Muscle Biopsy Level IV ​
​88348 ​ ​ EM ​
​88319 ​ ​11
Histochemistry stain:
1.    NADH-TR
2.    AMP (adenosine-5-monophosphate    deaminase)
3.    Esterase
4.    SDH (succinic dehydrogenase)
5.    COX (cytochrome oxidase)
6.    Acid Phosphatase
7.    Alkaline Phosphatase
8.    Phosphorylase
9.    ATPase at pH 9.4
10. ATPase at pH 4.45
11. ATPase at pH 4.2
 ​
​88342 ​ ​1 ​Immunohistochemistry single stain: HLA-ABC (MHC-1) (frozen tissue)
 ​
​88313 ​ ​2 ​Special Stain, Group 2 paraffin:
1.    Congo Red
2. Masson Trichrome
 ​
​88314 ​ ​4 ​Special Stain, frozen:
1.    Congo Red
2. Gomori's Trichrome
3. Oil Red O
4. PAS
 ​
Classification

This test should be regarded as 'Research Use Only'. This test has not been cleared or approved by the U.S. Food and Drug Administration. It may not be covered by insurance and providers need to inform all patients of this prior to ordering. 

For Medicare patients, an Advanced Beneficiary notice (ABN) is required; for Medicaid patients, a Noncovered Services Waiver is required, and for commercial payers, prior authorization should be obtained.   ​

​​

Synonyms/Keywords
Histology​
Ordering Applications
Ordering Application Description
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​Skeletal Muscle Petri Dish or Other Specimen Container  - closed with or without a Muscle Clamp​ ​

​With clamp, as thick as possible - 2.5 cm in length by 0.5 cm in diamter minimum.  Does not have to be stretched thin. 

Without a clamp, it should meaure at least 1.0 x 0.5 cm minimum after removal, as the muscle contracts.

 ​ ​
Collection Processing

Histology must be notified 24 hours in advance 715-221-6175.

The muscle biopsy must be sent “fresh” in an enclosed container to prevent drying out with slightly moistened saline gauze wrapped around the specimen. Do not submerge the samples in saline as this will cause a swelling artifact. Also, do not let the sample dry out which will cause enzyme activity to be lost. The specimen must remain in a refrigerated state immediately after biopsy and throughout transportation.

Muscle biopsy specimens will be accepted only if the following conditions are met.
• Must be received within 24 hours.
• Muscle specimens are only accepted Monday through Friday between 8:00 am - 4:00 pm. No specimens are accepted on weekends or holidays.
• Specimen container must be labeled STAT and deliver to Histology immediately.

Send/Deliver to:
Marshfield Labs-Histology Department 701 West Kalsched Ave, Laird N 4th floor Marshfield, WI 54449

Required information to be sent with the muscle biopsy:
• Completely fill out a Histology requisition form. Please call (715) 221-6700 Marshfield Labs Customer Service at 800-222-8535 for a Histology Requisition form.
• Clinical history-- brief and detailed clinical information (results of electromyography skeletal MRI if available).

Any questions please call the Marshfield Histology Lab 715-221-6175. ​

Acceptable Body Sites
​Various per clinician.
Acceptable Specimen Types
​Skeletal Muscle
Specimen Stability Information
Specimen Type Temperature Time
​Fresh Muscle ​Room Temperature ​< 30 minutes after removal
​Fresh Muscle ​Refrigerated ​> 30 minutes after removal and < 24 hours
Interference
Improperly handled – placed in any type of fixative will void testing other than performing routine histology and possibly other paraffin stains per pathologist. Additionally, if specimen is > 24 hours when received, the specimen quality may be compromised.
Useful For
A muscle biopsy can lead to the discovery of problems with the nervous system, connective tissue, vascular system, or musculoskeletal system. In humans with weakness and low muscle tone, a muscle biopsy can help distinguish between myopathy (where the pathology is in the muscle tissue itself) and neuropathy (where the pathology is at the nerves innervating those muscles), by microscopic analysis for differing characteristics when exposed to a variety of chemical reactions and stains.​
Reference Range Information
Performing Location Reference Range
​Marshfield ​Interpretive Report
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Marshfield ​Monday - Friday ​1 week ​Hematoxylin & Eosin, Histochemistry Stains,
Electron Microscopy, Immunohistochemistry, & Special Stains
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
88305 ​ ​1 Muscle Biopsy Level IV ​
​88348 ​ ​ EM ​
​88319 ​ ​11
Histochemistry stain:
1.    NADH-TR
2.    AMP (adenosine-5-monophosphate    deaminase)
3.    Esterase
4.    SDH (succinic dehydrogenase)
5.    COX (cytochrome oxidase)
6.    Acid Phosphatase
7.    Alkaline Phosphatase
8.    Phosphorylase
9.    ATPase at pH 9.4
10. ATPase at pH 4.45
11. ATPase at pH 4.2
 ​
​88342 ​ ​1 ​Immunohistochemistry single stain: HLA-ABC (MHC-1) (frozen tissue)
 ​
​88313 ​ ​2 ​Special Stain, Group 2 paraffin:
1.    Congo Red
2. Masson Trichrome
 ​
​88314 ​ ​4 ​Special Stain, frozen:
1.    Congo Red
2. Gomori's Trichrome
3. Oil Red O
4. PAS
 ​
Classification

This test should be regarded as 'Research Use Only'. This test has not been cleared or approved by the U.S. Food and Drug Administration. It may not be covered by insurance and providers need to inform all patients of this prior to ordering. 

For Medicare patients, an Advanced Beneficiary notice (ABN) is required; for Medicaid patients, a Noncovered Services Waiver is required, and for commercial payers, prior authorization should be obtained.   ​

​​

For most current information refer to the Marshfield Laboratory online reference manual.