Parkview Health Laboratory: Test Directory

Medicare Medical Necessity Restrictions May Apply

Medical Necessity Documentation:

Patient Preparation:

Specimen Requirements: 10.0 mL Whole Blood in (2) two Lavender Top Tubes - EDTA

Collection Instructions: Patient age required on order with all other requirements

Recent Transfusion information should be sent with specimen

Send in Lavendar tubes / Do not aliquot

Minimum volume notes
3mL if multiplex ligation-dependent probe amplification is desired

Minimum Volume: 1.0 - 3.0 mL Whole Blood

Transport & Storage: Temperature/Stability: 7 days Refrigerated

Reference Range:

Hemoglobin A:
1-30 days: 5.9-77.2%
1-2 months: 7.9-92.4%
3-5 months: 54.7-97.1%
6-8 months: 80.0-98.0%
9-12 months: 86.2-98.0%
13-17 months: 88.8-98.0%
18-23 months: 90.4-98.0%
> or =24 months: 95.8-98.0%

Hemoglobin A2:
1-30 days: 0.0-2.1%
1-2 months: 0.0-2.6%
3-5 months: 1.3-3.1%
> or =6 months: 2.0-3.3%

Hemoglobin F
1-30 days: 22.8-92.0%
1-2 months: 7.6-89.8%
3-5 months: 1.6-42.2%
6-8 months: 0.0-16.7%
9-12 months: 0.0-10.5%
13-17 months: 0.0-7.9%
18-23 months: 0.0-6.3%
> or =24 months: 0.0-0.9%

Varient: No abnormal variants
Varient 2:No abnormal variants
Varient 3:No abnormal variants

Critical Ranges:

Test Comments:

Methodology: Multiple

Clinical Significance:

Diagnosis of thalassemias and hemoglobin variants
Evaluation of unexplained microcytosis

Documentation:

Custom Panel: No

Turn Around Time: 2 days

Days Performed: Monday, Tuesday, Wednesday, Thursday, Friday, Saturday

Sites Performed: Mayo Laboratory

PHL Test Code: MSOT

EPIC Test Code: MISC

Send Out Test Code: HBEL1

Alternate Test Names: Alpha Globin Variant; A2 Hemoglobin; Barts Hemoglobin; Beta Globin Variant; Beta-Thalassemia; Fetal Hemoglobin; fetaldex (Hemoglobin F); Hemoglobin A2; Hemoglobin Cascade; Hemoglobin Electrophoresis Cascade; Hemoglobin Electrophoresis Cascade Level 1; Hemoglobin Electrophoresis Evaluation, Blood; Hemoglobin F; Hemoglobin Mass Spec Studies; Hemoglobin Molecular studies; Hemoglobin S, quant; Hemoglobin Variant; Hemoglobin-H Disease; HGB (Hemoglobin) Electrophoresis; Isoelectric Focusing; Sickling Test

Included Tests:

CPT Coding: 83020, 83021 (Reflex 82664, 83068, 83789, 88184)

Parkview Laboratory: Test Directory

Hemoglobin Electrophoresis Evaluation

PRODUCTION SCHEDULE