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Test Code THEVP Thalassemia and Hemoglobinopathy Evaluation

Additional Codes

UCL: YRL
Powerchart: Hemoglobinopathy Evaluation (HPLC)

Epic: LAB3445 Hemoglobinopathy, Thalassemia

Reporting Name

Thalassemia and Hemoglobinopathy Ev

Useful For

Diagnosis of thalassemia

Profile Information

Test ID Reporting Name Available Separately Always Performed
THEV Hemoglobinopathy Interpretation No Yes
A2F Hemoglobin A2 and F No Yes
HBEL Hemoglobin Electrophoresis, B No Yes
FERR Ferritin, S Yes Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
HPFH Hemoglobin F, Red Cell Distrib, B Yes No
SDEX Hemoglobin S, Scrn, B Yes No
IEF IEF Confirms No No
HGBMO HGB Electrophoresis, Molecular No No
MASS Hb Variant by Mass Spec, B No No
AGPBT Alpha-Globin Gene Analysis Yes, (order ATHAL) No
UNHB Unstable Hemoglobin, B No No

Testing Algorithm

This is a consultative evaluation in which the case will be evaluated at Mayo Medical Laboratories, the appropriate tests performed at an additional charge, and the results interpreted.

Performing Laboratory

Mayo Medical Laboratories in Rochester

Specimen Type

Serum
Whole Blood EDTA


Specimen Required


Forms:

1. Thalassemia/Hemoglobinopathy Patient Information (T358) in Special Instructions

2. New York Clients-Informed consent is required. Please document on the request form or electronic order that a copy is on file. An Informed Consent for Genetic Testing (T576) is available in Special Instructions.

3. If not ordering electronically, complete, print, and send a Benign Hematology Test Request Form (T755) with the specimen (http://www.mayomedicallaboratories.com/it-mmfiles/benign-hematology-test-request-form.pdf)

 

Patient's age and sex are required. Include recent transfusion information.

 

Blood and serum are required.

 

Specimen Type: Whole blood

Container/Tube: Lavender top (EDTA)

Specimen Volume: 15 mL

Collection Instructions: Label specimen as whole blood.

 

Specimen Type: Serum

Container/Tube: Red top or serum gel

Specimen Volume: 0.6 mL

Collection Instructions: Label specimen as serum.


Specimen Minimum Volume

Blood: 2.5 mL/Serum: 0.5 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated 7 days
Whole Blood EDTA Refrigerated 7 days

Reference Values

Definitive results and an interpretive report will be provided.

Day(s) and Time(s) Performed

Monday through Friday; Varies

CPT Code Information

Thalassemia and Hemoglobinopathy Evaluation

82728-Ferritin

83020-Hemoglobin electrophoresis

83021-Hemoglobin A2 and F

 

IEF Confirms

82664 (if appropriate)

 

Hemoglobin, Unstable, Blood

83068 (if appropriate)

 

Hemoglobin Variant by Mass Spectrometry

83789 (if appropriate)

 

Hemoglobin Electrophoresis, Molecular

81257-HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, Alpha thalassemia, Hb Bart hydrops fetalis syndrome, HBH disease) gene analysis for common deletions or variant (eg, Southeast Asian, Thai, Filipino, Mediterranean, alpha3.7, alpha4.2, alpha20.5, and Constant Spring) (if appropriate)

81401-HBB (hemoglobin, beta) (eg, sickle cell anemia, hemoglobin C, hemoglobin E), common variants (eg, HbS, HbC, HbE) (if appropriate)

81403-HBB (hemoglobin, beta, beta-globin) (eg, beta thalassemia), duplication/deletion analysis (if appropriate)

81404-HBB (hemoglobin, beta, beta-globin) (eg, thalassemia), full gene sequence (if appropriate)

 

Alpha Globin Gene Analysis

81257 x 2-HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, Alpha thalassemia, Hb Bart hydrops fetalis syndrome, HBH disease) gene analysis for common deletions or variant (eg, Southeast Asian, Thai, Filipino, Mediterranean, alpha3.7, alpha4.2, alpha20.5, and Constant Spring) (if appropriate)

 

Hemoglobin S, Screen, Blood

85660 (if appropriate)

 

Hemoglobin F, Red Cell Distribution, Blood

88184 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
THEVP Thalassemia and Hemoglobinopathy Ev In Process

 

Result ID Test Result Name Result LOINC Value
2380 Hemoglobin A 20572-4
FERR Ferritin, S 20567-4
2381 Hemoglobin A2 4551-8
583 Hemoglobinopathy Interpretation 59466-3
2382 Hemoglobin F 4576-5
2383 Variant 32017-6
29224 Variant 2 32017-6
29225 Variant 3 32017-6
2101 Interpretation 49316-3

Reject Due To

Hemolysis

Mild OK; Gross reject

Lipemia

NA

Icterus

NA

Other

NA

Method Name

THEV: Consultative Interpretation

A2F: Cation Exchange/High-Performance Liquid Chromatography (HPLC)

HBEL: Capillary Electrophoresis

FERR: Immunoenzymatic Assay

IEF: Electrophoresis

MASS: Mass Spectrometry (MS)

HGBMO: Polymerase Chain Reaction (PCR) Analysis/Multiplex Ligation-Dependent Probe Amplification (MLPA), Polymerase Chain Reaction (PCR)/DNA Sequencing

(PCR is utilized pursuant to a license agreement with Roche Molecular Systems, Inc.)

Test Classification

See Individual Test IDs