Acid Hgb

Test Code

ACHB

Alias/See Also

ACHB

CPT Codes
82664

Includes

ALK HGB ELECT

Preferred Specimen

EDTA Whole Blood - 2 Full Tubes

Minimum Volume

1 Full Tube EDTA whole blood

Instructions

ALK. HGB ELECT DONE AS PRELIMINARY TEST

Transport Container

PURPLE/2

Transport Temperature

RT or 2-8 degrees C

Specimen Stability

Stored up to 1 week at 2-6C

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Hemolyzed, Quantity not Sufficient, EDTA contamination,

Methodology
ELECT

Setup Schedule

Tuesday and Thursday

Report Available

Tuesday and Thursday - Upon Completion of Analysis

Limitations

Never freeze sample; Additional studies may be necessary to positively identify rare hemoglobins

Reference Range

The major hemoglobin in the erythrocytes of the normal adult is HbA with small amounts of HbA2 and HbF possible.

Clinical Significance

The major hemoglobin in the erythrocytes of the normal adult is HbA, but there are small amounts of HbA2 and HbF. In addition, over 400 mutant hemoglobins are now known, some of which may cause serious clinical effects, especially in the homozygous state or in combination with another abnormal hemoglobin. Wintrobe1 divides the abnormalities of hemoglobin synthesis into three groups. (1) Production of an abnormal protein molecule (e.g. sickle cell anemia) (2) Reduction in the amount of normal protein synthesis (e.g. thalassemia) (3) Developmental anomalies (e.g. hereditary persistence of fetal hemoglobin (HPFH)

The most common hemoglobin abnormalities:
Sickle Cell Trait - This is a heterozygous state showing HbA and HbS and a normal amount of HbA2 on cellulose acetate. Results on citrate agar show hemoglobins in the HbAand HbS migratory positions (zones).

Sickle Cell Anemia - This is a homozygous state showing almost exclusively HbS, although a small amount of HbF may also be present.

Sickle-C Disease - This is a heterozygous state demonstrating HbS and HbC.

Sickle Cell-Thalassemia Disease - This condition shows HbA, HbF, HbS, and HbA2.

In Sickle Cell b°-Thalassemia HbAis absent.

In Sickle Cell b+-Thalassemia HbA is present in reduced quantities.

Thalassemia-C Disease - This condition shows HbA, HbF and HbC.

C Disease - This is a homozygous state showing almost exclusively HbC.

Thalassemia Major - This condition shows HbF, HbAand HbA2.

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.