Ordering Recommendation

Optimal test to evaluate individuals with hereditary hemolytic anemia or unexplained long-standing hemolytic anemia. 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

This test is not New York state approved. There are no New York state-approved laboratories available and NYDOH is not accepting Non-permitted Laboratory Requests (NPL). Do not submit sample to ARUP.

Specimen Required

Patient Preparation

3 whole blood Lavender (K2EDTA) or Pink (K2EDTA) specimens and 3-5 peripheral blood smears.

Specimen Preparation

Transfer specimens using ARUP kit (ARUP supply # 54388) available online through eSupply using ARUP Connect or contact ARUP Client Services at (800) 522-2787.

Storage/Transport Temperature


Unacceptable Conditions

Submit with Order: 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)/Electrophoresis/RBC Solubility/Polymerase Chain Reaction/Fluorescence Resonance Energy Transfer/Sequencing/Spectrophotometry/Visual Identification/Quantitative Enzymatic Assay/Quantitative Flow Cytometry/Cytochemical Stain/Multiplex Ligation-Dependent Probe Amplification/Massively Parallel Sequencing





Reference Interval

Interpretive Data

Compliance Category

Laboratory Developed Test (LDT)


The Hereditary Hemolytic Anemia Cascade begins with initial standard tests to detect possible causes of hemolytic anemia. If the results of the initial tests are suggestive of an abnormal or unstable hemoglobin, RBC membrane instability, or an enzyme or protein deficiency; 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 reflex 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 and older. If quantitation of hemoglobin was performed before age one, repeat testing is recommended. Abnormal hemoglobin variants may require additional testing, which increases TAT up to 21 days.

Hotline History


CPT Codes

84220; 88184; 82955; 83021. Reflex components billed separately. Additional CPT codes may apply, 85555; 85060; 85007; 83068; 81269; 81259; 81363; 81364; 81249; 81443; 85660; 83020; 81479.


Component Test Code* Component Chart Name LOINC
3000908 Hereditary Hemolytic Anemia Interp
* 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.


Hereditary Hemolytic Anemia Cascade