Biopsy Protocol

Complete Procedure for Brain Biopsy in Prion Diseases

Prion Center Biopsy
  • It is very important that you inform us of any follow-up information you may obtain, such as familial history of dementia and rapid deterioration of the patient's condition. If CSF or brain materials are collected in the future, a portion should be frozen immediately and sent to us for further diagnosis.
  • Freeze 0.5 g of tissue, preferably from gray matter, for biochemical studies in a -70°C freezer (or, lacking that, in a -20°C freezer) and ship in dry ice. 0.5 g of tissue is the ideal amount, but we may be able to accept less if no additional tissue is available.
  • The remaining tissue should be fixed in 10% buffered formalin for at least 24 hours followed by 1 hour formic acid (range of formic acid should be between 88-98%) and then by at least 24 hours of additional fixation in formalin (the 24 hours includes shipping time). However, if the formic acid treatment cannot be performed, it can also be carried out after paraffin embedding on the tissue extracted from the melted paraffin block.

NOTE: Please send fixed and frozen tissue samples in separate containers to avoid freezing of the fixed tissue, which can result in artifacts. See the Shipping Instructions for more information.

P‌lease Note Policy Changes Effective May 1st, 2012

  • The National Prion Disease Pathology Surveillance Center (NPDPSC) will be charging for testing on brain biopsy tissue effective May 1st, 2012.
  • The ICD9 Code is 046.19. The CPT codes are 88371 and 88372 x 2 for Western blot analysis (on frozen biopsy tissue); the CPT codes are 88307 and 88342 for Histological analysis (on fixed biopsy tissue). 
  • In addition to our Test Request Form, all senders of biopsy tissue will be required to also complete and submit our CSF and Biopsy Billing Form ONLY if the NPDPSC is to bill patient directly.
  • For Roster/Client Billing, send out labs only need to submit our Test Request Form if NPDPSC is to bill lab/institution directly. 

If you have any questions regarding these policy changes, please contact us at 216.368.0587.

For billing questions, please contact our billing department at 877.854.3904.