Digitising the national genomic test directory

A genomic test is a single laboratory investigation - for example, a BRCA gene test, a FISH test, or whole genome sequencing. Each test has a specific purpose and targets specific genes or variants. In the new system, tests are identified with a GT number (e.g. GT485).

A test package is a collection of related genomic tests grouped together under a single clinical condition, or group of similar conditions - for example, Acute Myeloid Leukaemia or Cystic Fibrosis. It replaces what was previously called a "clinical indication. Packages are identified with a TP number (e.g. TP450).

Think of it like ordering from a restaurant menu. If you know exactly what you want you can order a specific dish – this is like ordering a specific test. You can also order from a section of the menu (such as "starters" or "from the grill") and let the kitchen advise on what's available and most appropriate – this is equivalent to ordering a test package.

In both cases, the kitchen decides what it can deliver based on what you've asked for.

Genomic ordering works the same way:

• Order a package if you know the suspected condition but aren't sure which specific test is needed. Staff at the genomics laboratory will review your request and determine the most appropriate test(s) for your patient.
• Order a specific test if you know exactly which investigation is required - for example, if you are a specialist who regularly orders the same test.
• In both cases, the genomics laboratory remains responsible for reviewing the request and confirming which tests will be performed.

When ordering, please ensure you provide all relevant clinical information as this will be used by the labs to help select or confirm appropriate test choice. This will help to avoid delays and increase the chance of obtaining a clinically actionable result.

No. You do not need to memorise any new codes. The system has a search function that works with text, R and M codes you already know and the new GT/TP identifiers. Any codes you currently use will continue to work.
However, to ensure clarity, you are encouraged to include your desired test codes when placing an order.

The previous test directory had overlapping and duplicated entries, which caused confusion. The new structure has:

• Merged duplicate tests into single entries (e.g. 17 separate DPYD tests are now one)
• Consolidated clinical indications into clearer packages (e.g. 12 B-Cell lymphoma clinical indications are now a single package)
• Created new packages for conditions where clinicians previously had to commit to a specific indication before a diagnosis was confirmed — which is no longer required

• Search or browse the NGTD website - the system supports synonyms and related terms to help you find the right package.
• Read the patient eligibility criteria to understand whether your patient is eligible for testing.
• There is a ‘Compare’ button on every test and package which allows you to compare two tests or two packages and help choose between options.
• If in doubt, contact your the East Genomics Laboratory for guidance.