Alpha-Globin Common Mutation Analysis (NY)

Test Code
11174


CPT Codes
81257<br /> **This test is not available for non-New York patient&nbsp;testing. For non-NY patient testing, use test code 11175.**

Physician Attestation of Informed Consent
This germline genetic test requires physician attestation that patient consent has been received if ordering medical facility is located in AK, DE, FL, GA, IA, MA, MN, NV, NJ, NY, OR, SD or VT or test is performed in MA.


Preferred Specimen
5 mL whole blood collected in EDTA (lavender-top) tube


Minimum Volume
3 mL


Other Acceptable Specimens
Whole blood collected in: EDTA (royal blue-top), sodium heparin (green-top), lithium heparin (green-top), ACD-B (yellow-top) or ACD-A (yellow-top) tube


Transport Temperature
Room temperature


Specimen Stability
Room temperature: 30 days
Refrigerated: 30 days
Frozen: 30 days


Methodology
Polymerase Chain Reaction (PCR)

FDA Status
This test was developed and its performance characteristics have been determined by Quest Diagnostics. Performance characteristics refer to the analytical performance of the test.

This test is performed pursuant to a license agreement with Roche Molecular Systems, Inc.

Setup Schedule
Sets up: Sun; Report available: 7 days


Clinical Significance
Alpha Thalassemia is a common hereditary trait and disease among individuals of Asian heritage. Disease ranges in severity from mild abnormalities of erythrocytic indices to severe anemia. Genetic counseling may be advised for some patients.




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.