Submitting Test data to GTR in Bulk using an Excel Submission Spreadsheet

OMB NO: 0925-0651

EXPIRATION DATE: 01/31/2025

General Requirements
- Download the GTR full test submission template
Download Previously Submitted Clinical Genetic Test Data
- Prepare a submission using the GTR full test submission template with all Clinical Test Fields
- Using the GTR minimal fields test submission template
Instructions for completing the full test submission file
Definitions and column values
Upload your completed spreadsheet.
- Submission notifications
Submission tips
- Variants
Validation error messages

This document provides detailed information about how to submit data to GTR describing the clinical tests you offer, via files you prepare in advance. Templates for the files to be uploaded are available from GTR's FTP site and from your laboratory home page in Submission Portal. Bulk submission of research tests is not enabled. For information on the other submission scenarios and formats available, please see http://www.ncbi.nlm.nih.gov/gtr/docs/submit/#scenarios.

General Requirements

All submission scenarios require that you first register your laboratory in the GTR using the interactive submission website.

Log into the NCBI Submission Portal
Register a new laboratory
If a member of your lab needs access to the Submission Portal group account for your lab, please contact GTR staff.

Download the GTR full test submission template

There are two ways to download the submission template with all clinical tests fields:

From the GTR FTP site, download the full test submission template file
To download your lab-specific template, from your home page in Submission Portal, go to the section 'Tests in this lab'. Then click on 'Submit tests' to go to the test submission page. See Submit multiple tests.

Download Previously Submitted Clinical Genetic Test Data

From your home page in Submission Portal, go to the section 'Tests in this lab'. Click on 'Download tests' to download your data. Clinical genetic tests and clinical microbe tests will be downloaded in separate spreadsheets to your Downloads folder. You will also receive an email, one for each test type, with a link to download the file. If you have only one test type (e.g., clinical genetic tests), then you will be reminded that there are no tests in the other category (ie., clinical microbe tests). You can use the data in the spreadsheet to submit updates to the tests.

Prepare a submission using the GTR full test submission template with all Clinical Test Fields

Review the instructions for completing the full test submission file. You may use the spreadsheet to:
- Add a new test
- Edit an existing test
- Delete an existing test
Complete the file according to instructions.
Upload your file
Correct processing errors, if any are found. The entire spreadsheet must pass validation; specific error-free tests will not be processed separately. See possible error messages.
Review the submitted test records on the GTR public web site. A GTR test record becomes available on the GTR public website following indexing, usually within 24-48 hours after successfully submitting the test.
Test field definitions and column values

Notes: Supporting documents, such as FDA approval documents and sample reports cannot be uploaded via the full test submission template. If you wish to add these files, please do so manually within the GTR submission interface found at https://submit.ncbi.nlm.nih.gov/subs/gtr.

Using the GTR minimal fields test submission template

For instructions on how to use the GTR minimal fields submission template, which contains a subset of fields, refer to Submitting data to GTR in bulk using an excel file with a subset of fields.

Instructions for completing the full test submission file

General features of the test submission file

This spreadsheet is used to provide the full set of test-specific data for clinical tests to GTR. The template includes minimal, recommended, and optional fields. Registration of each test is complete after the spreadsheet is successfully uploaded. You can add or edit fields at a later time using either the full test submission template, or by using the GTR submission user interface. For definitions of minimal, recommended, and optional fields, please go here.

The file does not have to reflect all tests offered by your laboratory. You can prepare and submit multiple test submission files. You can also enter and/or edit tests by using the interactive submission site.

Please do not edit rows that start with a # or that have a colored background.

A red triangle in the upper right of a cell indicates there is a comment. Hover over these cells to see abbreviated instructions on how to complete that cell.

Columns C, J, M, N, O, Q, R, U, X, AD, AE, AF, AG, AK, AN, AT, AU, AW, AX, AZ, BB, BN, BR, BU, BX, CD, CF, CI, CJ, CL, CR, CS, CT, provide pull-down menus. To complete those fields, first click the cell. A gray arrow will appear to the right of the cell. Click on the arrow to see the menu of allowed values and select from it. If you need to select multiple values click on the cell below to add another value. Please note carefully how to manage definitions of a test using multiple rows in the spreadsheet.

If order codes are unique for each test in your lab, and your lab does not have an internal tracking identifier, you can use the order code as your Test tracking ID.

The first column and the first row are frozen as default. However, you may want to unfreeze the first column or freeze another column (e.g. order code) to help keep track of which test you are working on. To do this go to the 'View' tab of the spreadsheet and click the freeze panes icon.

How to enter data

The form contains all available columns, or data fields, which you can use to provide data for a test. The first column is critical, because if your submission requires more than one row to describe a test completely, the value in the first column is used to recognize that these data all belong to the same test. In general, each row corresponds to a test target description. A test target is what the test interrogates (e.g., for clinical genetic tests, the analyte, chromosomal region/mitochondrion, gene or protein). For simple tests (i.e., one test target), one row corresponds to one test you want to register in GTR. Each set of test targets and linked attributes (e.g., condition the target is assessing, target category, name of what is tested, variants, RefSeq:exons) must be entered in one row so GTR can identify their interrelationship. Thus, a test with multiple test targets will have multiple rows, each with the same value in column A.

Each set of rows with the same Test tracking ID is processed as one test. For single tests that are described using multiple rows, please enter the same Test tracking ID in column A for each applicable row. GTR identifies specific tests via the Test tracking ID, therefore it is crucial that each test be assigned a unique id of your choosing.

The action column designates whether you are adding a new test, or editing or deleting an existing registered GTR test. If you are editing or deleting an existing GTR test, you MUST include the GTR test accession in column B. You can find the test accession number in your list of tests on the GTR submission site (far right column).

Each test target must be linked to at least one indication (condition or phenotype name). Multiple indications for the same test target can be separated by |. Indications placed in the same row as a test target will be connected to that specific target.

If the same indication (condition or phenotype) relates to more than one test target it must be repeated for each appropriate test target row.

Indications (condition or phenotypes) may be entered either as names or MIM numbers. We recommend that you search GTR to find condition/phenotype names recognized by GTR. Use of a recognized condition/phenotype name facilitates discovery of your test through the autocomplete dictionary and disease hierarchies, and enables your test to be linked to clinical, literature and consumer resources.

GTR does not accept registration of send-out tests (i.e. tests that are performed entirely at an outside laboratory/facility as explained here). At least one test component must be performed at the laboratory that is registering the test. If any part of the test is performed at an outside facility, you may enter 'No' for 'Test performance location' on the spreadsheet. In the next column, you should specify which components of the test are performed at an outside facility and subsequently provide additional information in the following comment cell.

For column/fields that have menu choices, you must select from the choices provided. If multiple choices are applicable, each must be entered in the row(s) below.

Novel conditions worksheet

The ‘Novel conditions’ worksheet should only be used if the condition for the test does not exist in GTR, that is, if it is a truly novel condition. To help prevent duplicate entries, please search GTR for the condition name before creating a new entry. Note that the condition name for your test may be listed as an alternate name for a GTR condition name. If the condition exists in GTR, submission processing will preferentially capture data stored in the GTR database from sources such as OMIM, HPO, GeneReviews, Orphanet, and Monarch/MONDO, and will ignore data provided in this worksheet for mode of inheritance, prevalence, and other fields.

Sample tests

A file with sample tests in the full test submission template can be downloaded here.

The sample tests are as follows:

Test 10001 demonstrates completion of all fields except for those recommended or optional fields which are not applicable

Test 10002 demonstrates completion of minimal fields only

Test 10003 demonstrates completion of minimal and applicable recommended fields

Definitions and column values

This table describes each value in the columns of the test submission file. The status column below (see key) indicates whether the field must be supplied to enable successful upload of the file and the impact on public display. On the full test submission template, minimal fields are highlighted so that they are differentiated from recommended and optional fields.

Four columns pertain to the spreadsheet submission process: (A) Test tracking ID, (B) GTR accession, (C) Action and (BS) Condition/phenotype: choose name or identifier source. All of the remaining columns correspond to fields that are part of overall GTR test submission.

Key for Status column

Private = field will not display to the public

Public = field will be viewable by GTR users

Minimal = field must be completed for this file to be processed successfully

Recommended = field will display as 'Not provided' if left blank

Optional = field will not display to the public if left blank (i.e. if not applicable for the test)

Lab Test Tab

Column	Status	Description	Hints
A	Minimal Private	Test tracking ID	ID to distinguish one test from another on this spreadsheet. This field must be completed for each line. If a single test has multiple lines of data, this field *must* have the same value for all lines of that test. If you have an internal ID, which will help you track your submission, provide it here. You can use your order code if unique for each test or you can come up with your own unique tracking code (e.g. 1,2,3,4,...)
B	Minimal* (if updating or deleting) Private	GTR Accession	Test ID to identify the GTR test you wish to edit or delete. This field should be empty if you are adding a new test, and must be completed if you are updating or deleting a test previously registered in the GTR.
C	Minimal Private	Action	Field used to determine which action to perform on the row(s) corresponding to a single test. Only enter once per test. Selections include: Update: Edit an existing GTR test Delete: Permanently remove an existing GTR test Add New: Create a new test registration No Change: Do nothing to the existing test registration
D	Recommended Public	Test order code	Enter the test order code, commonly found on the laboratory's requisition form, test menu or test catalog. This is the code health care providers (for example) would use to order the test through the laboratory. Complete this field only for the first line of data for each test.
E	Minimal Public	Laboratory test name	Test name as found on the lab test menu or requisition form. By default, test name is the record name in GTR and this is how you can easily identify your tests in your submission homepage. Complete this field only for the first line of data for each test.
F	Optional Public	Laboratory test short name	The short test name is the shortened name or mneumonic used by the lab to identify the test. This may be a test name used in conjunction with a test order code for quick test menus, electronic medical records or HL7 systems and programs. Examples include: CHD7Full. Complete this field only for the first line of data for each test.
G	Optional Public	Manufacturer's test name	Enter the manufacturer's name of the commerical test or kit used if in the submitted assay. If the test is an entirely laboratory developed test, there should not be a manufacturer's test name. Complete this field only for the first line of data for each test.
H	Optional Public	URL for the test	Enter the URL for test-specific information on your laboratory's website. URLs should be entered with the appropriate prefix, i.e., http:// or https://. Complete this field only for the first line of data for each test.
I	Optional Private	Search terms	Enter any search terms you wish to be associated with your submitted test. You do not need to enter keywords such as the disease/condition, gene, variant or test name. These will all automatically be included in a search. Relevant terms may include keywords such as archived or previously used test names. Limit to one search term per cell. Multiple search terms should be entered on multiple lines.
J	Minimal Public	Purpose of the test	Select the appropriate purpose or indication of the test. If you need to add multiple test purposes, use a new line for each purpose added. Definitions of choices can be found here. In the spreadsheet, you can select from the following list: Diagnosis Drug response Monitoring Mutation confirmation Pre-implantation genetic diagnosis Pre-symptomatic Predictive Prognostic Recurrence Risk assessment Screening Therapeutic management
K	Recommended Public	Target population for this test	Provide information on which population segment(s) the test is appropriate for and why. Complete this field once for each test. Example: Individuals with clinical symptoms consistent with Noonan syndrome.
L	Recommended Public	Citations for target population	PubMed identifiers preferred; otherwise, full citations or URLs. If multiple, separate by '\|'. This will allow GTR to provide a link for users to have easy access to the citation. You can also provide a link to your lab's webpage with information about the target population for this test.
M	Optional Public	Has there been FDA review of this test?	Select the option (Y/N) corresponding to if the test or any portion of the test including reagents has been reviewed or is pending review by the FDA. This field should only be completed once per test.
N	Optional Public	If no FDA review, FDA category designation	Select the appropriate option from the available choices: FDA exercises enforcement discretion Not applicable
O	Optional Public	If FDA review, item reviewed	This field is completed only when 'yes' is selected from the 'Has there been FDA review of this test?'. From the options indicated, select the portion of the test that has been reviewed or is pending review by the FDA. If multiple items reviewed, enter each item on a new line. Choices include: ASR - Analyte-specific reagents Assay(s) IVDMIA - In Vitro Diagnostic Multivariate Assay(s) Instrument(s) Test kit(s) Other- Please specify
P	Minimal* (if 'Other' selected in item reviewed) Public	Item reviewed, 'Other' value	Enter the text corresponding to the 'Other' value for Item reviewed.
Q	Optional Public	If FDA review, FDA category designation	This field is completed only when 'yes' is selected from the 'Has there been FDA review of this test?'. From the options indicated, select the category of FDA review. Choices include: IUO - Investigational Use Only -The performance characteristics of this product have not been established. IVD - In Vitro Device RUO - Research Use Only- Not for use in diagnostic procedures.
R	Optional Public	If FDA review, FDA regulatory status	This field is completed only when 'yes' is selected from the 'Has there been FDA review of this test?'. From the options provided, select the status of the item reviewed. Choices include: FDA cleared/approved FDA exempt Pending Not submitted Other-Please specify
S	Minimal* (if 'Other' selected in regulatory status) Public	Regulatory status, 'Other' value	Enter the corresponding 'Other' value for regulatory status.
T	Optional Public	If FDA review, application number	This field is completed only when 'yes' is selected from the 'Has there been FDA review of this test?'. Enter the FDA application number associated with the item reviewed.
U	Optional Public	NYS CLEP status	This field is required if 'NYS CLEP' is a valid certification for the specific test. Enter the status of the NYS CLEP approval for the test. This field should only be completed once per test. Options include: Approved Not approved Pending Grandfathered Exempt
V	Minimal* (if licensed by NYS) Public	NYS CLEP license number	This field is required if 'NYS CLEP' is a valid certification for the specific test. Enter the license number provided by NYS CLEP for the approved test. This field should only be completed once per test.
W	Recommended Public	Test development	Select a single option for how the test was developed. Intended to help delineate the differences in certification requirements between the test types. Do not include reflex tests here. Options include: FDA-reviewed (has FDA test name) -The test, test kit or reagents either have FDA approval or are currently in FDA review. Manufactured (research use only; not FDA-reviewed) -The test or primary parts of the test are purchased from a commercial entity and have not gone through FDA review. Modified FDA (has FDA-reviewed entry, but with lab modifications/field changes) -The test, test kit or reagents used in the test have undergone FDA review and are approved, however the submitting laboratory has augmented some part of the test or testing protocol. Test developed by laboratory (no manufacturer test name) -This test is developed, produced and performed by the submitting laboratory. Also known as LDT.
X	Recommended Public	How to order (text description)	Enter a description of the test ordering procedure, such as required forms, specimen handling/shipping instructions, etc. Requirements and recommendations about informed consent and genetic counseling can be discussed here. If applicable, a statement similar to the following can be used: “The laboratory recommends that pre- and post-test genetic counseling be offered and informed consent be obtained for this test but does not require documentation to accept and process the sample.” Complete this field only for the first line of data for this test.
Y	Recommended Public	How to order (URL)	Enter the URL for information on how to order the test. URLs should be entered with the appropriate prefix,i.e., http:// or https://. Complete this field only for the first line of data for this test.
Z	Recommended Public	Test codes (URL)	Enter the URL for information on corresponding codes related to the test, including CPT, ICD-9, ICD-10 and HCPCS codes. URLs should be entered with the appropriate prefix,i.e., http:// or https://. Complete this field only for the first line of data for this test.
AA	Optional Public	LOINC codes	The LOINC (Logical Observation Identifiers Names and Codes) database provides a set of universal names and ID codes for identifying laboratory and clinical test results. Enter the LOINC code. If applicable, the LOINC code can be found by using the 'Search' link, which will take you to the official LOINC website. The LOINC code must be entered manually, even if the submitter searches for the code using the link provided. Multiple codes should be entered on the same line, separated by '\|'.
AB	Optional Public	CPT codes	Enter a molecular pathology CPT code. Enter one CPT code per line. If you do not know which code(s) are appropriate for your test, you can review code descriptors on the GTR submission site by clicking edit on your test (once submitted) and navigating to the 'How to Order' tab. You will have to review and accept the AMA CPT code agreement before accessing the code descriptors.
AC	Optional Public	Who can order this test?	Identify who can order the test based on the laboratory's policy on how the test can be ordered. Multiple selections should be made on multiple lines for the test. Choose from the following options: Genetic counselor Health care provider In-state patients Licensed dentist Licensed physician Nurse practitioner Out-of-state patients Physician assistant Public health mandate Registered nurse
AD	Recommended Public	Informed consent required?	Identify if the laboratory requires informed consent prior to performing the test. Select from the following choices: Decline to answer Required Not required As required by state law If not required but recommended, you can comment in the 'How to order' text field.
AE	Recommended Public	Pre-test genetic counseling required?	Identifiy if the laboratory requires genetic counseling prior to performing the test. Select from the following choices: Decline to answer Required Not required If not required but recommended, you can comment in the 'How to order' text field.
AF	Recommended Public	Post-test genetic counseling required?	Identify if the laboratory requires genetic counseling after performing the test in order to release test results. Select from the following choices: Decline to answer Required Not required If not required but recommended, you can comment in the 'How to order' text field.
AG	Optional Public	Test service	If applicable, select the laboratory services that are offered in conjunction with the specific test. Multiple selections are allowed, but enter each on a separate line. Please select each test service only once (you can provide multiple order codes for one service in the order code field). This field is different from 'Laboratory services' which allows submitters to select general services the laboratory provides. Choose from the following options: Clinical testing/Confirmation of Mutations Identified Previously Confirmation of Research Findings Custom Balanced Chromosome Rearrangement Studies Custom Deletion/Duplication Testing Custom Sequence Analysis Data Storage and Backup Genetic Counseling Identity Testing Marker Chromosome Identification Preimplantation Genetic Diagnosis (PGD) Result Interpretation Specimen Source Identification Uniparental Disomy (UPD) Testing X-Chromosome Inactivation Studies
AH	Minimal* (if 'Other' is selected in test service) Public	Test service, 'Other' value	Enter the corresponding 'Other' value for test-specific services.
AI	Optional Public	Test service order code	If applicable, enter the order code for the test-specific service, commonly found on the laboratory's requisition form, test menu or test catalog. This is the code health care providers (for example) would use to order the service through the laboratory. If multiple services are entered, enter the associated order codes on separate corresponding lines.
AJ	Optional Public	Test service comment	Enter further information to assist health care providers in ordering the test-specific services. An example includes, 'Pre-test and post-test genetic counseling is available for this test'. If multiple services are entered, enter the associated test-specific comment on separate corresponding lines.
AK	Optional Public	Test additional service	If applicable, select the additional laboratory services that are offered in conjunction with the specific test. Enter multiple selections on separate lines. Please select each test service only once (you can provide multiple order codes for one service in the order code field). This field is different from 'Laboratory additional services' which allows submitters to select general services the laboratory provides. Options include: Custom prenatal testing Custom mutation-specific/Carrier testing
AL	Optional Public	Test additional service order code	If applicable, enter the order code for the test-specific additional service, commonly found on the laboratory's requisition form, test menu or test catalog. This is the code health care providers (for example) would use to order the service through the laboratory. If multiple services are entered, enter the associated order codes on separate corresponding lines.
AM	Optional Public	Test additional service comment	Enter further information to assist health care providers in ordering the additional test-specific services. An example includes, 'Once a mutation is identified, prenatal testing is available'. If multiple services are entered, enter the associated test-specific additional comment on separate corresponding lines.
AN	Recommended Public	Specimen source	Select the specimen type(s) allowed for the test. Multiple selections allowed. Each specimen type should be on a separate line. Choices include: Amniocytes Amniotic fluid Bone marrow Buccal swab Buffy coat Cell culture Cell-free DNA Cerebrospinal fluid Chorionic villi Cord blood Cystic hygroma fluid Dried blood spot (DBS) card Fetal blood Fibroblasts Fresh tissue Frozen tissue Isolated DNA Paraffin block Peripheral (whole) blood Plasma Product of conception (POC) Saliva Serum Skin Sputum Urine White blood cell prep Other-please specify
AO	Minimal* (if 'Other' is selected for specimen source) Public	Specimen source, 'Other' value	Enter the corresponding 'Other' value for specimen source.
AP	Recommended Public	Specimen source URL	Enter the URL to the laboratory's website that describes the specimen requirements and handling for the test. URLs should be entered with the appropriate prefix,i.e., http:// or https://.
AQ	Recommended Public	Testing strategy	Describe the suggested sequence of ordering tests, discuss reflex testing, testing algorithms and related issues. This field is for recommendations on how to order the test in sequence of relevance to the patient (target population) being tested. This field should not include discussion of methodologies or test procedural protocols. If describing reflex tests, each test component should be delineated. If a test is ordered, additional tests may be performed as necessary under certain circumstances based on initial results and that should be described in this field.
AR	Recommended Public	Citations to support testing strategy	Enter references and/or URLs as appropriate to further describe the testing strategy/algorithm. If entering an URL, please specify the appropriate prefix, http:// or https://. PubMed identifiers preferred; otherwise, full citations or URLs. If multiple, separate by'\|'.
AS	Recommended Public	Test-specific contact policy	Select the policy of the laboratory regarding who (patients or health care providers) and when (pre-test/post-test/anytime) can contact the lab for this test. If appropriate, select multiple options with each option on a separate line. Options include: Laboratory can only accept contact from health care providers. Patients/families are encouraged to discuss genetic testing options with their health care provider. Post-test email/phone consultation regarding genetic test results and interpretation is provided to patients/families. Pre-test email/phone consultation regarding genetic test results and interpretation is provided to patients/families.
AT	Recommended Public	Test-specific contact person	From the drop-down list, select the test-specific contact for thes test. This individual's name and contact information will be displayed on the test page for health care providers to view. If no test-specific contact is provided, the laboratory's general contact information will display. For multiple contacts, add each person on a separate line. Note: If you do not see the staff member's name you want to select in the personnel list, you either have downloaded a generic full test submission template (and not a pre-loaded laboratory-specific template) or, you need to add the person to your laboratory registration. Either way, you will not be able to add the person on the spreadsheet you are currently working on. We recommend skipping this field on your current spreadsheet and then manually adding the test-specific contact using the GTR submission site. See http://www.ncbi.nlm.nih.gov/gtr/docs/submit/test_order/for more information.
AU	Minimal Public	Test performance location(s):	Select where the test is performed from the following options. Tests which are performed entirely at an outside lab/facility should not be registered in GTR. 'In-house' means within the lab/facility covered by the same CLIA certification number. 'Outside lab' means a different lab/facility than that dovered by your CLIA certification, even if both labs have the same parent organization. Multiple selections are allowed,unless the entire test is performed in-house. Select each option on a separate line. Entire test performed in-house Interpretation performed at an outside lab Interpretation performed both in-house and at an outside lab Interpretation performed in-house Report generated at an outside lab Report generated both in-house and at an outside lab Report generated in-house Specimen preparation performed at an outside lab Specimen preparation performed both in-house and at an outside lab Specimen preparation performed in-house Wet lab work performed at an outside lab Wet lab work performed both in-house and at an outside lab Wet lab work performed in-house
AV	Minimal* (if any part of the test is peformed outside the registering laboratory) Public	Test performance location(s) comments	Briefly describe methods and location for components of test work done at an outside lab.
AW	Minimal Public	Method Category	Category of the method(s) being used in this test. If multiple methods are used in the test, add an additional line for each method. If your test uses more than one Test method per Method Category, you must select the category again in column AW to correspond to the value in column AX. To display the complete list of choices, please: 1. Click on the cell - an arrow displays to the right of the cell, then 2. Click on the gray arrow. Options include: Analyte Chromosome breakage studies Deletion/duplication analysis Detection of homozygosity Detection of homozygosity Enzyme assay FISH-interphase FISH-metaphase Fluorescence in situ hybridization (FISH) Immunohistochemistry Karyotyping Linkage analysis Methylation analysis Microsatellite instability testing (MSI) Multicolor FISH (M-FISH)/Spectral Karyotyping™ (SKY™) Mutation scanning of select exons Mutation scanning of the entire coding region Protein analysis Protein expression RNA analysis Sequence analysis of select exons Sequence analysis of the entire coding region Sister chromatid exchange Targeted variant analysis Uniparental disomy study (UPD)
AX	Minimal Public	Test method	Select the test method that corresponds to the entry selected in column 'AW' for Method category. Each test must have an entry both in column 'AW' and column 'AX'. If the test has multiple test methods, add each test method on a new line, making certain the Test method value corresponds to the value in Method category. If the test method used in this test is not listed, please select 'Other' from the list in the spreadsheet and specify the test method in column 'AY'. To display the complete list of choices, please: 1. Click on the cell - an arrow displays to the right of the cell, then 2. Click on the gray arrow. Options include: Allele-specific primer extension (ASPE) Alternative splicing detection Bi-directional Sanger Sequence Analysis C-banding Chemiluminescent Immunoassay (CIA) Chromatin Immunoprecipitation on ChIP Comparative Genomic Hybridization DamID Digital / Virtual karyotyping Digital microfluidic microspheres Enzymatic levels Enzyme activity Enzyme-Linked Immunosorbent Assays (ELISA) Fluorescence in situ hybridization (FISH) Fluorometry Fusion genes microarrays G-banding Gas chromatography–mass spectrometry (GC-MS) Gene expression profiling GeneID Gold nanoparticle probe technology High-performance liquid chromatography (HPLC) Liquid chromatography-tandem mass spectrometry (LC-MS/MS) Liquid chromatography–mass spectrometry (LC-MS) Metabolite levels Methylation-specific PCR Microarray Multiplex Ligation-dependent Probe Amplification (MLPA) Next-Generation (NGS)/Massively parallel sequencing (MPS) Oligonucleotide Ligation Assay (OLA) Oligonucleotide hybridization-based DNA sequencing PCR PCR with allele specific hybridization PCR-RFLP with Southern hybridization Protein truncation test Pyrosequencing Q-banding Quantitative PCR (qPCR) R-banding RFLP RT-LAMP RT-PCR RT-PCR with gel analysis RT-qPCR SNP Detection Silver staining Spectral karyotyping (SKY) T-banding Tandem mass spectrometry (MS/MS) Tetra-nucleotide repeat by PCR or Southern Blot Tiling Arrays Trinucleotide repeat by PCR or Southern Blot Uni-directional Sanger sequencing> Other-please specify
AY	Minimal* (if 'Other' is selected for test method) Public	Test method, 'Other' value	Enter the corresponding 'Other' value for test method.
AZ	Recommended Public	Instruments used for test method	Name the instrucment used for a specific methodology. Enter each instrument on a separate line, corresponding to the appropriate test method. Affymetrix GeneChip Scanner 3000 7G Whole-Genome Association System Affymetrix GeneTitan® MC Affymetrix HotStart-IT Probe qPCR Master Mix with UDG (2X) Agilent 2100 Bioanalyzer Agilent SureSelect Applied Biosystems 3730 capillary sequencing instrument Applied Biosystems 7900HT Sequence Detection System Applied Biosystems SOLiD v4 System Sequencer BeadXpress® Reader BioRad CFX96 Covaris S2 Sonicator GenMark Diagnostics eSensor XT-8 system Illumina Genome AnalyzerIIx and Genome AnalyzerIIe Illumina HiScan[TM] SQ system Illumina HiSeq[TM] 2000 system Other PerkinElmer Victor3 1420 Multilabel Plate Reader Qiagen AutoPure LS Qiagen QIAcube Roche LightCycler 480 Tecan Genesis Robotic Workstation 150
BA	Minimal* (if 'Other' is selected for instruments) Public	Instruments, 'Other' value	Enter the corresponding 'Other' value for instruments.
BB	Optional Public	Platforms	Select the name of a platform used in your test, if appropriate. If you use a platform not on the list, choose 'Other' and then provide the name. A platform name typically corresponds to a unique catalogue number or a set of catalogue numbers which are bundled with other consumables. The format is usually manufacturer name, product name, and general specifications. Affymetrix CytoScan HD Array Affymetrix Gene Profiling Array cGMP U133 P2 Affymetrix GeneChip Human Genome U133 Plus 2.0 Array Affymetrix GeneChip Human Mitochondrial Resequencing Array 2.0 Affymetrix Genome-Wide Human SNP Array 6.0 Affymetrix QuantiGene 2.0 Assay Agilent Human CpG Island Microarray Kit, 1x244K Agilent Human ENCODE ChIP-on-chip Microarray Agilent Human miRNA Microarray Kit Release 16.0, 8x60K Agilent SurePrint G3 Human CGH Microarray Kit, 2x400K Amersham CodeLink UniSet Human I Bioarray Illumina Infinium HD HumanCytoSNP-12 Life Technologies TaqMan OpenArray MicroRNA Panels NimbleGen CGH 3-plex ISCA Plus Cytogenetic Array None/not applicable Other Oxford Gene Technology CytoSure DMD (4x44k) Oxford Gene Technology CytoSure ISCA UPD (4x180k) Oxford Gene Technology CytoSure ISCA v2 (4x180k) Oxford Gene Technology CytoSure ISCA v2 (4x44k) Oxford Gene Technology CytoSure ISCA v2 (8x60k) Oxford Gene Technology CytoSure Syndrome Plus v2 (2x105k)
BC	Minimal* (if 'Other' is selected for platform) Public	Platform, 'Other' value	Enter the corresponding 'Other' value for platforms.
BD	Optional Public	Test procedure or protocol	Summarize the methodology and descrie the specific steps for each method of the assay.
BE	Optional Public	Citations to support test procedure or protocol	Provide citations or URL for the protocol. PubMed identifiers preferred; otherwise, full citations or URLs. If multiple, separate by'\|'. URLs should be entered with the appropriate prefix,i.e.,http:// or https://.
BF	Recommended Public	Confirmation of test results	Describe whether and how test results are confirmed (beyond initial validation of the assay). For example, 'Positive results are confirmed on a new DNA preparation using sequence analysis'.
BG	Optional Public	Test comment	Provide textual description of the test methods or any other information about your test not described elsewhere that may be useful to clinicians ordering your test, e.g. 'Bi-directional sequencing of exons 1-5 with concurrent analysis of NP_000000.0:p.Glu234Gly'.
BH	Minimal Public	Analytical Validity	The Analytical validity field needs a statement that includes quantitative information for analytical sensitivity, analytical specificity, accuracy, and/or precision of this test. General statements about methodologies that do not contain specific information about the test do not satisfy the specifications for this field. Nor do statements such as "N/A", "not applicable", "Yes" or "unknown". Example: 'The OtoChip is greater than 99% sensitive for detecting substitution variants in the sequence analyzed. In addition, this assay is 95% sensitive for detecting small insertions or deletions (inDels), and 100% for 1-2bp indels, 92.3% for 3-5bp indels and 87.5% for >10bp indels.'
BI	Recommended Public	Citations to support analytical validity	Provide PubMed ID when available, otherwise full citations or URLs. If multiple, separate by'\|'. URLs should be entered with the appropriate prefix, i.e., http:// or https://. This will allow GTR to provide a link for users to have easy access to the citation. If no publications are available, provide non-proprietary internal lab data in analytical validity statement, if available. You can also provide a link to your lab's webpage with information about analytical validity for this test.
BJ	Recommended Public	Clinical validity	Clinical validity is how consistently and accurately the test detects or predicts the intermediate or final outcomes of interest. This information will display in the Overview and Indication tabs of the test record. Describe clinical sensitivity and specificity, positive and negative predictive values, the population(s) assessed, adn the number of specimens used to calculate clinical validity. Clinical sensitivity is the proportion of positive test results among patients with the defined clinical presentation. Clincal specificity is the proportion of negative test results among patients witout the defined clinical presentation. Positive predictive value is the chance of having the marker among those that test positive. Negative predictive value is the chance of not having the marker among those that test negative.
BK	Recommended Public	Citations to support clinical validity	Provide citations to support clinical validity statment. Provide PubMed ID when available, otherwise full citations or URLs. If multiple, separate by '\|'. URLs should be entered with the appropriate prefix, i.e., http:// or https://.
BL	Recommended Public	Assay limitations	Describe any factors that affect the value of the test for its intended use. Includes limits of detection and validation of test for only specific subpopulations or particular uses.
BM	Recommended Public	Citations to support assay limitations	Provide citations to support assay limitation statements. Provide PubMed ID when available, otherwise full citations or URLs. URLs should be entered with the appropriate prefix, i.e., http:// or https://. If multiple, separate by '\|'.
BN	Recommended Public	Clinical utility category	Select a category from the list and support it with an URL and/or citations. Enter multiple clinical utitity statements on separate lines. Choose from the following options: Avoidance of invasive testing Establish or confirm diagnosis Guidance for management Guidance for selecting a drug therapy and/or dose Lifestyle planning Predictive risk information for patient and/or family members Reproductive decision-making Sufficient research has not been conducted to establish utility of the test Other (please specify)
BO	Minimal* (if 'Other' is selected for Clinical utility category) Public	Clinical utility category other value	Enter the corresponding 'Other' value for Clinical utility category.
BP	Minimal* (if a clinical utility category is chosen, a citation or URL is required) Public	URL to explain clinical utility	Cite recommendations or practice guidelines for the test that have been issued by authoritative groups. Some practice guidelines may be available via URL but not a citation. URL to the laboratory web page may be used. URLs should be entered with the appropriate prefix, i.e., http:// or https://. If multiple clinical utility statements, enter on separate lines, with each corresponding to the appropriate entry in column BN.
BQ	Minimal* (if a clinical utility category is chosen, a citation or URL is required) Public	Citations to support clinical utility	Provide citations to support clinical utility statements. Provide PubMed ID when available, otherwise full ciations. URLs should be entered with the appropriate prefix, i.e., http:// or https://. If multiple clinical utility statements, enter on separate lines, with each corresponding to the appropriate entry in column BN. If multiple citations for a single clinical utility statement, enter on the same row, but separate by '\|'.
BR	Minimal Private	Condition/phenotype: choose name or identifier source	Select whether the condition/phenotype will be provided by condition name or identifier (OMIM, CUI, HPO, Orphanet, MeSH, or MONDO). You can find the GTR preferred name by searching the public web site at http://www.ncbi.nlm.nih.gov/gtr. In the spreadsheet, you can select from the following list: condition name CUI HPO identifier MeSH ID MIM number MONDO ID Orphanet identifier
BS	Minimal Public	Conditions/Phenotypes	If you selected MIM number in previous column (BR), enter the valid MIM condition number (please do not enter MIM number for gene records). If you enter a MIM number for the condition being tested, GTR will use this to match your submission to disorders already represented in GTR's database. Similarly, if you selected one of the other identifier sources in Column BR, enter the valid identifier here. The list of names GTR uses per MIM number is provided from the ClinVar's FTP site. If you selected condition name in column BR, write the preferred name of the condition/phenotype. You can search GTR to find the condition name in the database. Linking to an existing condition name ensures that this test will be connected to available resources such as clinical and molecular resources. Learn how to use MedGen to select condition and phenotype terms. If multiple conditions/phenotypes exist for a single target (columns BT through BV), enter values separated by a vertical bar (\|). If same condition/phenotype exists for multiple targets, the conditon/phenotype must be repeated on each target line.
BT	Minimal Public	Germline or Somatic	Select the type of target from the following options: Germline Somatic Both
BU	Minimal Public	Target category	Select the category describing the test target measures in the test. If multiple targets are being tested, add each target on a separate line. In the spreadsheet, you can select from the following list: analyte chromosomal region/mitochondrion gene protein Note that gene is used to represent molecular assays that detect variations in a gene or set of genes.
BV	Minimal Public	Name of what is tested	If gene in column BU, enter HGNC official gene symbol. If chromosomal region/mitochondrion in column BU, enter region. If protein, please use Swiss-Prot protein name. If an analyte, enter its name. If multiple targets are being tested, each target must be stored on a separate line. Examples: Analyte: 'Branched-chain amino acids' or the enzyme 'Branched-chain ketoacid dehydrogenase' Chromosomal region/mitochondrion: '11q15' or 'm.7446-m.7514' Gene: 'CDKN2A' or 'CFTR' Protein: 'Hemoglobin subunit beta' or 'Adenomatous polyposis coli protein'
BW	Optional Public	Variants(s)	Describe variation using fully qualified HGVS expression,e.g.NM_000258.2:c.427G>A. If multiple variants for Conditions/phenotypes named in Column BS, separate with '\|'. Fill this column only if gene is provided in column BV. Example: for a test that interrogates the 1477_1478del and 1477C>T of the CFTR gene for Cystic fibrosis, you would enter: Column BR: MIM number Column BS: 219700 Column BT: Germline Column BU: gene Column BV: CFTR Column BW: NM_000492.4:c.1477_1478del\|NM_000492.4:c.1477C>T
BX	Optional Public	Clinical significance of variant	Assign the clinical significance of the variant(s) entered in column BW. Options include: Affects association association not found Benign confers sensitivity conflicting data from submitters drug response Likely benign Likely pathogenic not provided other Pathogenic protective risk factor Uncertain significance
BY	Optional Public	Citations to support the clinical significance	Provide citations to support assay limitation statements. Provide PubMed ID when available, otherwise full citations or URLs. URLs should be entered with the appropriate prefix, i.e., http:// or https://. If multiple, separate by '\|'. Citations should be entered on lines corresponding to associated clinical significance statment, entered in column BX.
BZ	Optional Public	RefSeq:relevant exons	Provide details about the exons analyzed and specify the associated reference sequences. Format by first specifying reference sequence, include assession number and version, then using ':', and then listing exons. If multiple reference sequences per gene, separate these by '\|'. Valid only if gene is provided in column BV. The RefSeq defining the exon numbering system must be supplied in this column. Example: NM_4433221.1:1-5(all)\|NM_123456.1:1,3,4-5 including 5 bp in intron-exon boundaries. If a continuous range is tested: provide the exon numbers as a range,e.g. 2-5. If the range includes all exons, add (All),e.g. 1-5 (All) If a subset is tested: enumerate the exons tested. Ranges are allowed,e.g.3,5,9-12 NOTE: If gene name is provided, the chromosomal location (RefSeq) will be automatically provided and does not need to be entered UNLESS you are providing exons.
CA	Recommended Public	VUS: What is the protocol for interpreting a variation as a VUS?	Describe how your lab interprets a variation as a VUS.
CB	Optional Public	VUS: What software is used to interpret novel variations?	Describe the software your lab uses to interpret novel variations. You can include lab-developed software.
CC	Recommended Public	VUS: What is the laboratory's policy on reporting novel variations?	Describe how your lab reports novel variations.
CD	Recommended Public	VUS: Are family members recruited without charge?	Select from the provided options: Not provided Yes No Decline to answer
CE	Recommended Public	VUS: Comments about recruiting family members.	Describe if your lab offers testing for a variant of unknown significance to family members free of charge; for example, to affected individuals and/or presumed obligate carriers to help determine clinical significance of a VUS. Write an explanation or give information about who would be eligible to testing free of charge and how the lab does it.
CF	Recommended Public	VUS: Will the lab re-contact the ordering physician if variant interpretation changes?	Select from the provided options: Not provided Yes No Decline to answer
CG	Recommended Public	VUS: Comments about re-contacting the ordering physician	Type a description or explanation about how the lab monitors and addresses reinterpretation of genetic test results over time, after issuing the report. For example, is there a time limit, do you systematically re-evaluate prior interpretations and generate new reports, or does the person ordering the test need to peridically recontact the laboratry to inquire about changes in test interpretation?
CH	Recommended Public	Research performed after clinical testing is complete	Describe any research testing being performed using the submitted sample after clinical testing is complete. For example, research testing is allowed under IRB approved protocols or the patient would have to sign an informed consent for the research protocol. If the protocol is registered in clincaltrials.gov, you can enter that information here. Please note, Quality Control is not considered as research for this question.
CI	Recommended Public	Is proficiency testing performed for this test?	Select Yes or No to indicate whether the test is subject to periodic internal or external evaluation of the accuracy of test results.
CJ	Minimal* (if 'Yes' is selected for PT performed) Public	Proficiency testing method	Specify which type of proficiency testing is performed. Proficiency testing is a determination of laboratory testing performance by means of interlaboratory comparisons wherby a group of laboratories receive multiple specimens for analysis and/or identification and the program compares the results among laboratories and/or with an assigned valude. Alternative assessment is the determination of laboratory testing performance by means other than PT such as split-sample testing or testing by a different method. Choices include: Alternative Assessment Formal PT program Inter-Laboratory Intra-Laboratory Other
CK	Minimal* (if 'Other' is selected for PT method) Public	Proficiency testing method, 'Other' value	Enter the corresponding 'Other' value for proficiency testing method.
CL	Recommended Public	Provider for proficiency testing	Specify the agency or society that administers the proficiency testing program for the test. Options include: American College of Medical Genetics / College of American Pathologists, ACMG/CAP American College of Physicians - Medical Laboratory Evaluation, ACP MLE Association for Molecular Pathology, AMP Belgian Official EKE Schemes, GLP Monitoring Programme Canadian External Quality Assessment Laboratory, CEQAL Centers for Disease Control and Prevention Newborn Screening Quality Assurance Program, CDC DLS Clinical Pathology Accreditation (UK) Ltd., CPA College of American Pathologists, CAP European Concerted Action on Thrombosis External Quality Assessment Program, ECAT EQAP European Molecular Genetics Quality Network, EMQN European Research Network for the Evaluation and Improvement of Screening Diagnosis and Treatment of Inherited Metabolic Disorders - External Quality Assessment Schemes, ERNDIM EQAS External Quality Assessment for Molecular Genetic Testing for Phenylketonuria, EQA-PKU Human Genetic Society of Australasia, HGSA Institute for Standardization and Documentation in the Medical Laboratory, INSTAND Other Pacific Northwest Regional Genetics Group, PacNoRGG Society for Inherited Metabolic Disorders, SIMD
CM	Minimal* (if 'Other' is selected for Provider for proficiency testing) Public	Provider for proficiency testing other value	Enter the corresponding 'Other' value for provider for proficiency testing.
CN	Recommended Public	Description of proficiency testing method	Explain proficiency testing (PT) method and provide PT scores and/or results, the PT reportable range, the PT interval and the number of specimens tested.
CO	Recommended Public	Citations to support proficiency testing description	Provide citations to support assay limitation statements. Provide PubMed ID when available, otherwise full citations or URLs. URLs should be entered with the appropriate prefix, i.e., http:// or https://. If multiple, separate by '\|'.
CP	Recommended Public	Description of internal test validation method	Explain how the laboratory validates the test.
CQ	Recommended Public	Citations to support internal test validation description	Provide citations to support assay limitation statements. Provide PubMed ID when available, otherwise full citations or URLs. URLs should be entered with the appropriate prefix, i.e., http:// or https://. If multiple, separate by '\|'.
CR	Recommended Public	Major CAP category	If College of American Pathologists (CAP) is chosen as Provider for proficiency testing, select Major CAP category from list. Add multiple as needed by entering on a separate line. Choices include: ABO Subgroup Typing Alpha-1 Antitrypsin (SERPINA1) Genotyping Anti-HCV, Rapid Methods, Waived ... For the complete, current list of choices for this field, see https://ftp.ncbi.nlm.nih.gov/pub/GTR/standard_terms/CAP_test_categories.txt.
CS	Recommended Public	CAP category	If Major CAP category is selected, specify relevant sub-category. Add multiple as needed by entering on separate lines, corresponding to entry in column CR. Choices include: 10q (PTEN) deletion ABO grouping ABO grouping (includes A subtyping)... For the complete, current list of choices for this field, see https://ftp.ncbi.nlm.nih.gov/pub/GTR/standard_terms/CAP_test_list.txt.
CT	Optional Public	CAP test list	Choose the appropriate test code corresponding to the CAP category if provided. Choices include: AAT ABO ABOSG ... For the complete, current list of choices for this field, see https://ftp.ncbi.nlm.nih.gov/pub/GTR/standard_terms/CAP_test_codes.txt.

Novel Condition Tab

Column	Status	Description	Hints
A	Minimal* (if providing novel condition) Public	#Conditions/Phenotypes	Enter your novel condition/phenotype name. To be sure the condition is novel, please search the GTR public web site (www.ncbi.nlm.nih.gov/gtr) for condition names. Note, your term may be an alternate term for a GTR condition name. Searching GTR will help prevent duplicate entries and ease test discovery for health care providers. If known, provide the term as the SNOMED CT preferred terminology.
B	Minimal* (if providing novel condition) Private	Indication type	Choose the category most appropriate for your novel condition/phenotype term. Options include: Disease Pharmacological response Named protein variant Blood group Finding Quantitative trait
C	Optional Public	Lab displayed condition preferred name	If the term submitted in column A is the SNOMED CT preferred term, but you would like a different term displayed for your test, enter the alternate term here. This should be a single term.
D	Optional Public	Suggest synonyms for condition	Enter synonyms for the novel condition.
E	Optional Public	Lab displayed acronym for the condition	Enter your preferred acronym for the novel condition. This should be a single term.
F	Optional Private	Suggest acronyms for condition	Enter acronyms for the novel condition.
G	Optional Private	Mode of inheritance for the condition	Select the mode of inheritance for the novel condition. Options include: Autosomal dominant inheritance Autosomal recessive inheritance Autosomal unknown Codominant Genetic anticipation Mitochondrial inheritance Other Sex-limited autosomal dominant Somatic mutation Sporadic X-linked dominant inheritance X-linked inheritance X-linked recessive inheritance Y-linked inheritance
H	Minimal* (if 'Other' selected in column 'G')	Mode of inheritance, 'Other' value	If 'Other' was selected in column G, please specify the new term.
I	Optional Private	Disease mechanism for the condition	Describe the disease mechanism for the relationship of condition to test target. Options include: Other Gain of function Loss of function
J	Minimal* (if 'Other' selected in column 'I')	Disease mechanism, 'Other' value	If 'Other' was selected in column I, please specify the new term.
K	Optional Private	Prevalence (text description)	Enter the prevalence, or the most current estimated number of cases of the disease in the population.
L	Optional Private	Prevalence (URL)	If 'Prevalence' is provided, either an URL or a citation is recommened to support the prevalence claim. URLs should be entered with the appropriate prefix, i.e., http:// or https://.
M	Optional Private	Citations to support prevalence	If 'Prevalence' is provided, either an URL or a citation is recommended to support the prevalence claim. Please enter PubMed ID if known, otherwise full citation.
N	Optional Private	Comments to GTR staff about condition	Enter information for GTR staff regarding the addition of a novel condition/phenotype name to the GTR database. Please include reasoning and if you searched for the term on the GTR public site. Citations are useful when GTR staff evaluates the novel condition.

Upload your completed spreadsheet.

From your home page in Submission Portal, go to the section 'Tests in this lab'. Then click on 'Submit tests' to go to the test submission page. See Submit multiple tests.

Submission notifications

You will receive a notification via email within a few minutes of uploading your file.

Success. If your spreadsheet is successfully uploaded, you will receive an email entitled 'Your tests submitted in bulk have been successfully registered in GTR'.
Warnings. If your speadsheet is successfully uploaded but has tests with order codes that match tests you already submitted to GTR, you will receive an email with warnings for the list of tests that have the same order codes as tests already in the GTR. You can review these tests in the submission user interface, in case they were submitted in error as duplicates or the order codes need to be edited. Distinct tests can have the same order code, so you are not required to make edits. This validation step is performed to help you detect possible duplications in your submissions.
Errors. If your spreadsheet contains errors and cannot be processed, , you will receive an email with the list of errors. You will need to correct these errors and resubmit your spreadsheet. See the list of errors and how to address them.

Once the spreadsheet has been successfully processed, the tests uploaded will display in your GTR Submission Portal homepage, under 'Tests in this lab'. If successful, your tests will display on the GTR public web site following indexing, within 24-48 hours.

Submission tips

Variants

HGVS expressions:

When submitting variants use the fully qualified HGVS expression. Use the Refseq assession with version (Accession.version) for a complete expression, preferably only including the nucleotide change.

Examples:
Gene: FBN1
Variant: NM_000138.5:c.8512A>T

Gene: DHCR7
Variant: NM_001360.3:c.964-1G>C

You may use the following tools to validate HGVS expressions prior to submission:

Mutalyzer
Variant Validatator

Submitting variant data in the spreadsheet

For the full template spreadsheet submission, if there are multiple variants for a Condition or phenotype, use the pipe delimiter ("|") to separate them.

Example: for a test that interrogates the 1477_1478del and 1477C>T of the CFTR gene for Cystic fibrosis, you would enter:

Column BR: MIM number
Column BS: 219700
Column BT: Germline
Column BU: gene
Column BV: CFTR
Column BW: NM_000492.4:c.1477_1478del|NM_000492.4:c.1477C>T

Clinical significance of the variant

When multiple variants are separated by a pipe delimiter ("|"), if provided, the clinical significance and citation are associated with each variant. For a variant to have a distinct clinical significance and citation, enter the variant in a new row, with its own clinical significance.

Validation error messages

Once your file is uploaded, the submission processing software performs validation checks on the data. Errors will be flagged in the email notification. You will need to make the apppropriate edits to the data to address these errors and then upload the file again.

Cell with missing values (required fields only, for a list of required fields, please see the table 'Definitions and column values').
Cell contains multiple values whereas only a single value is allowed.
The number of values between certain cells is required to match. Some cells are interdependent; for example, each test target needs to be linked to at least one indication.
The condition/phenotype name is not recognized by GTR. Please check the syntax or spelling of the terms you enter. You can find recognized terms by searching GTR.
The MIM number is not recognized as a condition record. Please make sure that all MIM numbers correspond to a condition/phenotype record in OMIM (i.e., MIM numbers for gene records are not accepted as condition identifiers).
The entry for 'Name of what is tested' does not match a gene symbol in the GTR database, which uses symbols from the HUGO Gene Nomenclature Committee (HGNC). Please review entries for misspellings and/or search GTR for recognized gene symbols.
Value entered does not match any of the allowed values, e.g., in a controlled field list such as 'Purpose of the test'. Check the options available in the column.
Test performance location(s): Either entire test in-house, or all test work location must be specified (Specimen preparation; Wet lab work; Interpretation; Generate report).
Permission error. If the current login account is not associated with the lab.
AMA license agreement is required if CPT code is provided in Excel file. The submitter must read and agree to the AMA license agreement prior to uploading a full test submission file with CPT codes entered. Please log into the submission site and review the AMA license agreement.
Un-recognized column header or empty header in the Excel fiel, e.g., column has been renamed by user.
Excel file error, such as the file is not an Excel file, or the file does not have a 'lab test' worksheet, or we cannot read data from the file.
Database error during validation. This is the rare case when the database connection is broken during validation. Please try uploading again.

Processing also checks for order codes that match tests already registered by your lab in GTR and if found, will generate a warning message. This is not considered to be an error. Laboratories may use the same order code for different tests, so this check is meant to alert you to the possibility of duplication or a typographical error in entering a code. This message is information for your consideration and will not halt processing of your file.