Epic Build / Desired Build Test Compendium
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Prenatal Fragile X Syndrome (FMR1) Epic Compendium  

▶ Desired Epic Build * = editable field  

Actual Epic Build 12/05/2025

PROCEDURE ID 192144
PDM 255302
ORDER DISPLAY NAME Prenatal Fragile X Syndrome (FMR1)
PROCEDURE NAME PRENATAL FRAGILE X SYNDROME
PROCEDURE MASTER NUMBER LAB14537
SHORT PROCEDURE NAME PRENATAL FRAGILE X SYNDROME
CATEGORY CODE 21.0
CATEGORY CODE RECORD NAME LAB MOLECULAR DIAGNOSTICS ORDERABLES
SYNONYMS FRX
CLINICALLY ACTIVE Yes
ORDERABLE Yes
PERFORMABLE Yes
FILTER GENOMICS
REFERENCE LINK URL https://labs.northwell.edu/epic/test/192144
ORDERING INSTRUCTIONS
DEFAULT SPECIMEN TYPE Amniotic Fluid
SPECIMEN TYPE PICK LIST Amniotic Fluid
SPECIMEN TYPE LIST Blood
OP SPECIMEN TYPE LIST Amniotic Fluid
SPECIMEN SOURCE PICK LIST Amniotic Sac
SPECIMEN SOURCE DEFAULT - MALE
SPECIMEN SOURCE DEFAULT - FEMALE Amniotic Sac
SPECIMEN SOURCE LIST Blood, Venous
OP SPECIMEN SOURCE LIST
IP LAB TEST COMPONENTS FOR REPORT PREFRAGXSYN
VARIANTINFO
OP LAB TEST COMPONENTS FOR REPORT PREFRAGXSYN
VARIANTINFO
ORDER QUESTIONS ["3045300170", "3045300171", "3045300173"]
ORDER QUESTIONS RECORD NAME NH IP HOME COLLECT DATE
NH IP HOME COLLECT DAYS
NH IP HOME COLLECT MEDICALLY NECESSARY
INPATIENT ORDER QUESTIONS ["3048500000"]
INPATIENT ORDER QUESTIONS RECORD NAME
ORDER SPECIFIC QUESTION OVERRIDE Yes
INPATIENT QUESTION OVERRIDE
LOCATION RESTRICT LIST IP
LOCATION RESTRICT LIST IP RECORD NAME
LOCATION RESTRICT LIST INCLUDE IP
LOCATION RESTRICT LIST OP
LOCATION RESTRICT LIST OP RECORD NAME
LOCATION RESTRICT LIST INCLUDES OP
EDP AMB ORDER SPECIFIC QUESTIONS RECORD NAME NH IP PATIENT COMPLETED CONSENT
EDP IP ORDER SPECIFIC QUESTIONS RECORD NAME NH IP PATIENT COMPLETED CONSENT
EDP IP SPECIMEN SOURCE
EDP OP SPECIMEN SOURCE
EDP IP SPECIMEN TYPE
EDP OP SPECIMEN TYPE
DERIVED EDP IP BUTTONS S
DERIVED EDP IP BUTTONS T
DERIVED EDP OP BUTTONS S
DERIVED EDP OP BUTTONS T
IP ORDERABLE 1
OP ORDERABLE 1
STANDARD LAB COMPONENTS
STANDARD LAB COMPONENTS RECORD NAME
COMPONENT DATA REQUIREMENT
EPIC OP AOEs

Question IDQuestion NameQuestionResponse TypeResponse ListRequire Response
3045300170 NH IP HOME COLLECT DATE Start Date Date Yes
3045300171 NH IP HOME COLLECT DAYS Days Custom List Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday		 Yes
3045300173 NH IP HOME COLLECT MEDICALLY NECESSARY Medically Necessary? Yes/No Yes
EPIC IP AOEs

Question IDQuestion NameQuestionResponse TypeResponse ListRequire Response
3048500000 NH IP PATIENT COMPLETED CONSENT Patient completed consent? Yes/No Yes
EPIC Components (results - crosswalked through Cerner)

Component IDComponent NameBase NameCommon NameExternal NameCerner Result PDM
3047808322.0 PRENATAL FRAGILE X SYNDROME PREFRAGXSYN PRENATAL FRAGILE X SYNDROME Prenatal Fragile X Syndrome 255302A