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22527 Hgb Electrophoresis Cascade (HBELC)

Hgb Electrophoresis Cascade (HBELC)
Test Code: HBESO
Synonyms/Keywords
​Lab Ref Code:  81626, A2 Hemoglobin, Alpha Globin Variant, Barts Hemoglobin, Beta Globin Variant, Beta-Thalassemia, Hemoglobin A2, Hemoglobin Cascade, Hemoglobin Electrophoresis Cascade Level 1, Hemoglobin Mass Spec Studies, Hemoglobin Molecular studies, Hemoglobin Variant, Hemoglobin-H Disease, HGB(Hemoglobin) Electrophoresis, Isoelectric Focusing, Sickling Test, Alpha Thalassemia, Microcytosis, Sickle cell, Thalassemia
Useful For
Diagnosis and comprehensive classification of thalassemias and hemoglobin variants
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
Whole Blood​ ​EDTA Lavender Top Tube (LTT) ​ 10 mL​ ​1 mL ​
Collection Processing Instructions
Collection Instructions: Do not transfer blood to other containers.
Additional Information:
1. Patient's age is required.
2. Include recent transfusion information.
3. Include most recent CBC results. 
4. For information on thalassemias and appropriate test ordering, see Thalassemia Tests in Special Instructions.
 
Forms:
Specimen Stability Information
Specimen Type Temperature Time
​Whole Blood ​Refrigerated ​7 days
Rejection Criteria

No specimen should be rejected. 

Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Mayo Medical Laboratories​​
Monday through Saturday 
​		 2-25 days if structural and/or molecular studies are required​
A2F/83341: Cation Exchange/High-Performance Liquid Chromatography (HPLC)
HBEL/81428: Capillary Electrophoresis
UNHB/9095: Isopropanol Stability
IEF/81644: Isoelectric Focusing
HPFH/8270: Flow Cytometry
MASS/60286: Mass Spectrometry (MS)
HBELA:  Consultative Interpretation
Reference Lab
Mayo Clinic Laboratories
Test Information
Hemoglobin electrophoresis cascade will always include hemoglobin A(2) and F and hemoglobin electrophoresis utilizing cation HPLC and capillary electrophoresis methods.
 
Reflex testing-Hemoglobin electrophoresis reflex testing performed at additional charge, may include any or all of the following as indicated to identify rare hemoglobin variants present: hemoglobin S screen, unstable hemoglobin, IEF confirms, hemoglobin variant by mass spec, alpha globin gene analysis, hemoglobin F red cell distribution, alpha-globin gene sequencing, and beta-globin gene sequencing, beta globin cluster locus del/dup, gamma globin full gene sequencing and HGB electrophoresis summary interp.
Reference Range Information
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%
 
VARIANT
No abnormal variants
 
VARIANT 2
No abnormal variants
 
VARIANT 3
No abnormal variants
Interpretation
​The types of hemoglobin present are identified, quantitated, and an interpretive report is issued
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​83021 ​ ​1 ​Quantitation by HPLC
​83020 ​ ​1 ​Quantitation by electrophoresis
82664​ ​ ​1 Electrophoresis, not elsewhere specified ​​ If Appropriate​​​
​83068 ​ ​1 Hemoglobin, Unstable Screen​​ If Appropriate​​​
​83789 ​ ​1 Hemoglobin Variant by Mass Spectrometry​​ If Appropriate​​​
​81259 ​ ​1 Alpha Globin Gene Sequencing If Appropriate​​​
​81364 ​ ​1 Beta Globin Gene Sequencing If Appropriate​​​
​81363 ​ ​1 Beta Globin Cluster Locus Del/Dup If Appropriate​​​
​85660 ​ ​1
Hemoglobin S, Screen
 If Appropriate​​​
88184​ ​ ​1 Hemoglobin F, Red Blood Cell Distribution​​ If Appropriate​​​
81479​ ​ ​1 ​Gamma Globin Full Gene Sequencing ​If Appropriate​​​
​88235 ​ ​1 ​Amniotic Fluid Culture ​​If Appropriate​​​
88240​ ​ ​2 ​Cryopreservation ​​​If Appropriate
​88233 ​ ​1 ​Tissue Culture Skin/Biopsy ​​​​If Appropriate
​81265 ​ ​1 ​Comp analysis using STR ​​​​​If Appropriate
​81266 ​ ​1 ​Additional comp analysis w/STR ​​​​​If Appropriate
​81269​​1​Alpha-Globin Gene Analysis​If Appropriate
Synonyms/Keywords
​Lab Ref Code:  81626, A2 Hemoglobin, Alpha Globin Variant, Barts Hemoglobin, Beta Globin Variant, Beta-Thalassemia, Hemoglobin A2, Hemoglobin Cascade, Hemoglobin Electrophoresis Cascade Level 1, Hemoglobin Mass Spec Studies, Hemoglobin Molecular studies, Hemoglobin Variant, Hemoglobin-H Disease, HGB(Hemoglobin) Electrophoresis, Isoelectric Focusing, Sickling Test, Alpha Thalassemia, Microcytosis, Sickle cell, Thalassemia
Ordering Applications
Ordering Application Description
​Centricity ​Hemoglobin Electrophoresis
​Cerner ​Hemoglobin Electrophoresis Cascade (81626)
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
Whole Blood​ ​EDTA Lavender Top Tube (LTT) ​ 10 mL​ ​1 mL ​
Collection Processing
Collection Instructions: Do not transfer blood to other containers.
Additional Information:
1. Patient's age is required.
2. Include recent transfusion information.
3. Include most recent CBC results. 
4. For information on thalassemias and appropriate test ordering, see Thalassemia Tests in Special Instructions.
 
Forms:
Specimen Stability Information
Specimen Type Temperature Time
​Whole Blood ​Refrigerated ​7 days
Rejection Criteria

No specimen should be rejected. 

Useful For
Diagnosis and comprehensive classification of thalassemias and hemoglobin variants
Reference Range Information
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%
 
VARIANT
No abnormal variants
 
VARIANT 2
No abnormal variants
 
VARIANT 3
No abnormal variants
Interpretation
​The types of hemoglobin present are identified, quantitated, and an interpretive report is issued
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Mayo Medical Laboratories​​
Monday through Saturday 
​		 2-25 days if structural and/or molecular studies are required​
A2F/83341: Cation Exchange/High-Performance Liquid Chromatography (HPLC)
HBEL/81428: Capillary Electrophoresis
UNHB/9095: Isopropanol Stability
IEF/81644: Isoelectric Focusing
HPFH/8270: Flow Cytometry
MASS/60286: Mass Spectrometry (MS)
HBELA:  Consultative Interpretation
Reference Lab
Mayo Clinic Laboratories
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​83021 ​ ​1 ​Quantitation by HPLC
​83020 ​ ​1 ​Quantitation by electrophoresis
82664​ ​ ​1 Electrophoresis, not elsewhere specified ​​ If Appropriate​​​
​83068 ​ ​1 Hemoglobin, Unstable Screen​​ If Appropriate​​​
​83789 ​ ​1 Hemoglobin Variant by Mass Spectrometry​​ If Appropriate​​​
​81259 ​ ​1 Alpha Globin Gene Sequencing If Appropriate​​​
​81364 ​ ​1 Beta Globin Gene Sequencing If Appropriate​​​
​81363 ​ ​1 Beta Globin Cluster Locus Del/Dup If Appropriate​​​
​85660 ​ ​1
Hemoglobin S, Screen
 If Appropriate​​​
88184​ ​ ​1 Hemoglobin F, Red Blood Cell Distribution​​ If Appropriate​​​
81479​ ​ ​1 ​Gamma Globin Full Gene Sequencing ​If Appropriate​​​
​88235 ​ ​1 ​Amniotic Fluid Culture ​​If Appropriate​​​
88240​ ​ ​2 ​Cryopreservation ​​​If Appropriate
​88233 ​ ​1 ​Tissue Culture Skin/Biopsy ​​​​If Appropriate
​81265 ​ ​1 ​Comp analysis using STR ​​​​​If Appropriate
​81266 ​ ​1 ​Additional comp analysis w/STR ​​​​​If Appropriate
​81269​​1​Alpha-Globin Gene Analysis​If Appropriate
For most current information refer to the Marshfield Laboratory online reference manual.