Hemoglobin Evaluation Reflexive Cascade
Ordering Recommendation

Optimal test for the initial and confirmatory diagnosis of any suspected hemoglobinopathy. A faculty hematopathologist personally directs and interprets each stage of testing to completion. A comprehensive report is provided. Do not use for the follow-up of an individual with a known diagnosis.

High Performance Liquid Chromatography/Electrophoresis/RBC Solubility/Polymerase Chain Reaction/Fluorescence Resonance Energy Transfer/Sequencing
New York DOH Approval Status
Specimens from New York clients will be sent out to a New York DOH approved laboratory, if possible.
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
Lavender (EDTA) or pink (K2EDTA). 
Specimen Preparation
Transport 5 mL whole blood. (Min: 2 mL) 
Storage/Transport Temperature
Unacceptable Conditions
Frozen or room temperature specimens. 
Patient history form, including information from a recent CBC, is required for interpretation. 
Ambient: Unacceptable; Refrigerated: 1 week; Frozen: Unacceptable 
Reference Interval
Effective August 19, 2013
HPLC testing
Age-Defined Normal Hemoglobin Reference Intervals
Hb A Percent
Hb A2 Percent
Hb F Percent
Hb S Percent
Hb C Percent
Hb E Percent
Hb Other Percent
0-1 month7.6-54.80.0-1.445.8-
2 months14.7-70.10.0-2.032.7-
3 months26.6-81.80.1-2.614.5-
4 months43.0-89.50.8-3.04.2-
5 months60.8-94.01.5-3.31.0-
6-8 months78.2-96.61.8-3.50.9-
9-12 months86.1-97.21.9-3.50.6-
13-23 months85.1-97.71.9-3.50.0-
2 years and older95.0-97.92.0-3.50.0-

Interpretive Data

The Hemoglobin Evaluation Reflexive Cascade begins with HPLC analysis. If an abnormal hemoglobin is detected or if the CBC data is suggestive of a hemoglobinopathy, appropriate testing will be performed at an additional charge. Depending on findings, one or more reflexive tests may be required in order to provide a clinical interpretation. Tests added may include electrophoresis, solubility testing, mutational analysis and/or sequencing.

Quantitation of hemoglobin by HPLC or electrophoresis is most definitive in individuals one year of age and older. If quantitation of hemoglobin was performed before one year of age, repeat testing is recommended. Abnormal hemoglobin variants may require additional testing, which increases TAT up to 21 days.
Hotline History
View Hotline History
CPT Code(s)
83021. If reflexed additional CPT codes may apply; refer to the reflexed test code for applicable codes.
Component Test Code*Component Chart NameLOINC
0050295Hemoglobin A4547-6
0050300Hemoglobin A24551-8
0050305Hemoglobin C4563-3
0050310Hemoglobin E4575-7
0050315Hemoglobin F4576-5
0050320Hemoglobin - Other48343-8
0050325Hemoglobin S4625-0
0050611Hemoglobin Evaluation21026-0
0081270Sickle Cell Solubility6864-3
2005800Beta Globin Full Gene Sequencing
2005802Alpha Thalassemia HBA1 and HBA2 Seq
2005804Hemoglobin Lepore (HBD/HBB) 3 Mutations
2005805Hemoglobin Cascade Interpretation50398-7
2008793Hemoglobin, Capillary Electrophoresis13514-5
2010236Beta Globin (HBB) Del/Dup Result
2011645Alpha Globin (HBA1 and HBA2) Del/Dup Rst
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
  • A2 Hemoglobin
  • Alpha Globin (HBA1 and HBA2) Sequencing
  • Alpha Globin Variant
  • Alpha Thalassemia (HBA1 &HBA2) 7
  • Barts Hemoglobin
  • Beta Globin (HBB) Sequencing and Deletion/Duplicaton
  • Beta Globin Variant
  • Beta-Thalassemia
  • Fetal Hemoglobin
  • fetaldex (Hemoglobin F)
  • Hemoglobin A2
  • Hemoglobin Cascade
  • Hemoglobin Electrophoresis Cascade Level 1
  • Hemoglobin F
  • Hemoglobin Lepore (HBD/HBB Fusion) 3 Mutations
  • Hemoglobin Mass Spec Stud
  • Sickle Cell Solubility