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Test Code Surg Path Musc Biopsy Surgical Pathology, Muscle Biopsy

Important Note

Order as "HMISC"

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.

Synonyms/Keywords

Histology

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.

    

Acceptable Body Sites

Various per clinician

Acceptable Specimen Types

Skeletal Muscle

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.

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

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.  

 

Interferences

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.

Reference Range Information

Performing Location Reference Range
Marshfield Interpretive Report

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.  

 

Marshfield Labs Performing Department

Marshfield Labs Histology

Performing 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

CPT Codes

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  

Outreach CPT Codes

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