Hemoglobin Evaluation Reflexive Cascade
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.
New York DOH Approval Status
Lavender (K 2 EDTA) or pink (K 2 EDTA).
Transport 5mL whole blood. (Min: 3 mL)
Refrigerated. Separate specimens must be submitted when multiple tests are ordered.
Patient history form, including information from a recent CBC, is required for interpretation.
Ambient: Unacceptable; Refrigerated: 1 week; Frozen: Unacceptable
High Performance Liquid Chromatography (HPLC)/Capillary Electrophoresis/RBC Solubility/Polymerase Chain Reaction (PCR)/Fluorescence Resonance Energy Transfer (FRET)/Sequencing/Massively Parallel Sequencing
Effective August 19, 2013
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
|2 years and older||95.0-97.9||2.0-3.5||0.0-2.1||0.0||0.0||0.0||0.0|
This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.
Laboratory Developed Test (LDT)
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.
83021. If reflexed additional CPT codes may apply; refer to the reflexed test code for applicable codes.
|Component Test Code*||Component Chart Name||LOINC|
|0050320||Hemoglobin - Other||48343-8|
|0081270||Sickle Cell Solubility||6864-3|
|2005800||Beta Globin Full Gene Sequencing|
|2005802||Alpha Thalassemia HBA1 and HBA2 Seq|
|2005805||Hemoglobin Cascade Interpretation||50398-7|
|2008793||Hemoglobin, Capillary Electrophoresis||13514-5|
|2010236||Beta Globin (HBB) Del/Dup Result|
|2011645||Alpha Globin (HBA1 and HBA2) Del/Dup Rst|
|3003512||Gamma Globin (HBG1 and HBG2) Sequencing||95795-1|
- 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
- Fetal Hemoglobin
- fetaldex (Hemoglobin F)
- Gamma Globin (HBG1 and HBG2) Sequencing
- Hemoglobin A2
- Hemoglobin Cascade
- Hemoglobin Electrophoresis Cascade Level 1
- Hemoglobin F
- Hemoglobin Mass Spec Stud
- Sickle Cell Solubility