Spreadsheet: 87e41614-1614-42a6-bd70-b539ced5b330
Sheet: Sheet1

Test Referenced | Entry Type | Mayo ID | Description | Reporting Description | Method | Collection Container | Temperature | Stability | [NAME] | Unit of Measure | [NAME] | Minimum Volume | Reject Due To | Reference Values | Days/Times Performed | Analytic Time | Maximum Lab Time | CPT Units | CPT Code | LOINC® Code | LOINC® Attributes | Always Performed | Orderable Separately | Performing Location
THEVP | Test | THEVP | Thalassemia and Hemoglobinopathy Evaluation | Thalassemia and [NAME] | THEV: Consultative Interpretation A2F: Cation Exchange/High-Performance Liquid Chromatography (HPLC) HBEL: Capillary Electrophoresis FERR: Immunoenzymatic Assay IEF: Electrophoresis MASS: Mass Spectrometry (MS) HGBMO: Polymerase Chain Reaction (PCR) Analysis/Multiplex Ligation-Dependent Probe Amplification (MLPA), Polymerase Chain Reaction (PCR)/DNA Sequencing (PCR is utilized pursuant to a license agreement with Roche Molecular Systems, Inc.) | EDTA (lavender-top) tube: EDTA OR Serum Gel Tube: SGT OR |  |  |  |  | Forms: 1. Thalassemia/Hemoglobinopathy Patient Information Sheet (Supply T358) in Special Instructions 2. New York Clients-Informed consent is required. Please document on the request form or electronic order that a copy is on file. An Informed Consent for Genetic Testing (Supply T576) is available in Special Instructions. 3. If not ordering electronically, please submit a Hematopathology/Molecular Oncology Request Form (Supply T241) with the specimen.   Patient's age and sex are required. Include recent transfusion information.   Blood and serum are required.   Specimen Type: Whole blood Container/Tube: Lavender top (EDTA) [NAME]: 15 mL Collection Instructions: Label specimen as whole blood.   [NAME] Type: Serum Container/Tube: Red top or serum gel [NAME]: 0.6 mL Collection Instructions: Label specimen as serum. | Blood: 2.5 mL/Serum: 0.5 mL | Hemolysis	Mild OK; Gross reject Thawing	NA Lipemia	NA Icterus	NA Other	NA | Definitive results and an interpretive report will be provided. | Monday through Friday; Varies | 2-25 days (if Structural or Molecular are required) | 25 days |  | Profile |  |  |  |  | Rochester
THEVP | [NAME] | SERUM | Serum |  |  |  | Refrigerated | 7 days
THEVP | [NAME] | WBEDTA | [NAME] EDTA |  |  |  | Refrigerated | 7 days
THEVP | Component | [NAME] | Hemoglobinopathy Interpretation | Hemoglobinopathy Interpretation | This is a consultative interpretation for THEVP / Thalassemia and Hemoglobinopathy Evaluation. | EDTA (lavender-top) tube: EDTA |  |  |  |  |  |  |  | Definitive results and an interpretive report will be provided. | Monday through Friday; Varies | 3 days (not reported Saturday or Sunday) | 30 days |  |  |  |  | Yes | No
[NAME] | [NAME] | WBEDTA | [NAME] EDTA |  |  |  | Refrigerated | 7 days
[NAME] | Result | 583 | Hemoglobinopathy Interpretation | Hemoglobinopathy Interpretation | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 59466-3
THEVP | Component | A2F | [NAME] and F, Blood | [NAME] and F | Cation Exchange/High-Performance Liquid Chromatography (HPLC) |  |  |  | 3 | mL | Container/Tube: Preferred: Lavender top (EDTA) Acceptable: ACD, heparin [NAME]: 3 mL Collection Instructions:  1. Submit fresh specimen. 2. Do not transfer blood to other containers. Additional Information: Patient's age is required. Forms:  1. Thalassemia/Hemoglobinopathy Patient Information Sheet (Supply T358) in Special Instructions 2. If not ordering electronically, please submit a Hematopathology/Molecular Oncology Request Form (Supply T241) with the specimen. | 1 mL | Hemolysis	Mild OK; Gross OK Thawing	NA Lipemia	NA Icterus	NA Other	NA | [NAME]: 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% | Monday through Saturday; 7 a.m. and 1 p.m. | Same day/1 day | 2 days | 1 | 83021 |  |  | Yes | Yes
A2F | [NAME] | WBEDTA | [NAME] EDTA |  |  |  | Refrigerated | 7 days
A2F | Result | 2381 | [NAME] | [NAME] | Numeric |  |  |  |  | % |  |  |  |  |  |  |  |  |  | 4551-8 | [NAME]/Hemoglobin.total:MFr:Pt:[NAME]:Qn:
A2F | Result | 2382 | [NAME] | [NAME] | Numeric |  |  |  |  | % |  |  |  |  |  |  |  |  |  | 4576-5 | [NAME]MFr:Pt:[NAME]:Qn:
THEVP | Component | HBEL | [NAME], Blood | [NAME], B | Capillary Electrophoresis |  |  |  | 1 | mL | Only orderable as part of a profile. For further information see HBELC/81626 Hemoglobin Electrophoresis Cascade, Blood. | 1 mL |  | 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%  VARIANT No abnormal variants  VARIANT 2 No abnormal variants  VARIANT 3 No abnormal variants |  |  |  | 1 | 83020 |  |  | Yes | No
HBEL | [NAME] | WBEDTA | [NAME] EDTA |  |  |  | Refrigerated | 7 days
HBEL | Result | 2380 | Hemoglobin A | Hemoglobin A | Numeric |  |  |  |  | % |  |  |  |  |  |  |  |  |  | 20572-4 | Hemoglobin A/Hemoglobin.total:MFr:Pt:[NAME]:Qn:Electrophoresis
HBEL | Result | 2383 | Variant | Variant | Alphanumeric |  |  |  |  | % |  |  |  |  |  |  |  |  |  | 32017-6 | Hemoglobin.other/Hemoglobin.total:MFr:Pt:Bld:Qn:Electrophoresis
HBEL | Result | 29224 | [NAME] | [NAME] | Alphanumeric |  |  |  |  | % |  |  |  |  |  |  |  |  |  | In Process
HBEL | Result | 29225 | [NAME] | [NAME] | Alphanumeric |  |  |  |  | % |  |  |  |  |  |  |  |  |  | In Process
HBEL | Result | 2101 | Interpretation | Interpretation | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 49316-3 | Hemoglobin pattern:Imp:Pt:[NAME]:Nom:Electrophoresis
THEVP | Component | FERR | Ferritin, Serum | Ferritin, S | Immunoenzymatic Assay | Serum Gel Tube: SGT |  |  | 0.5 | mL | Container/Tube:  Preferred: Serum gel Acceptable: Red top [NAME]: 0.6 mL | 0.5 mL | Hemolysis	Mild OK; Gross reject Thawing	Warm OK; Cold OK  Lipemia	Mild OK; [NAME] OK Icterus	NA Other	NA | Males: 24-336 mcg/L Females: 11-307 mcg/L | Monday through Friday; 6 a.m.-4 p.m. | Same day/1 day | 2 days | 1 | 82728 |  |  | Yes | Yes
FERR | [NAME] | SERUM | Serum |  |  |  | Refrigerated | 7 days
FERR | Result | FERR | Ferritin, S | Ferritin, S | Numeric |  |  |  |  | mcg/L |  |  |  |  |  |  |  |  |  | 2276-4 | Ferritin:MCnc:Pt:Ser/Plas:Qn:
THEVP | [NAME] | HPFH | [NAME], Red Cell Distribution, Blood | [NAME], Red Cell Distrib, B | Flow Cytometry | EDTA (lavender-top) tube: EDTA |  |  | 3 | mL | Container/Tube: Lavender top (EDTA) [NAME]: 3 mL Additional Information: 1. Patient's age and sex are required. 2. Indicate the percent of hemoglobin F. If this is not indicated, we will perform HBF/8269 [NAME], Blood. If HBF/8269 [NAME], Blood gives normal results, HPFH/8270 [NAME], Red Cell Distribution, Blood will not be performed. 3. Indicate the reason for testing. 4. For information on thalassemias and appropriate test ordering, see Thalassemia Tests in Special Instructions. | 0.5 mL | Hemolysis	Mild reject; Gross reject Thawing	Warm reject; Cold reject Lipemia	Mild OK; [NAME] OK Icterus	NA Other	NA | Reported as heterocellular or homocellular | Monday through Saturday; Continuously | 2 days (Not reported on Saturday or Sunday) | 5 days | 1 | 88184 |  |  | No | Yes
HPFH | [NAME] | WBEDTA | [NAME] EDTA |  |  |  | Refrigerated | 10 days
HPFH | Result | 8270 | [NAME], Red Cell Distrib, B | [NAME], Red Cell Distrib, B | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 4579-9 | [NAME]:Pt:[NAME]:Ord:
HPFH | Result | 2104 | Interpretation | Interpretation | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 59466-3
THEVP | [NAME] | UNHB | Unstable Hemoglobin, Blood | Unstable Hemoglobin, B | Isopropanol Stability | EDTA (lavender-top) tube: EDTA |  |  | 4 | mL | Container/Tube: Preferred: Lavender top (EDTA) Acceptable: ACD, heparin [NAME]: 4 mL Additional Information: 1. Patient's age is required.  2. For information on thalassemias and appropriate test ordering, see Thalassemia Tests in Special Instructions. Forms:  1. Thalassemia/Hemoglobinopathy Patient Information Sheet (Supply T358) in Special Instructions 2. If not ordering electronically, please submit a Hematopathology/Molecular Oncology Request Form (Supply T241) with the specimen. | 1 mL | Hemolysis	Mild OK; Gross OK Thawing	NA Lipemia	NA Icterus	NA Other	NA | Normal (reported as normal [stable] or abnormal [unstable]) | Monday through Friday; 10:30 a.m. | 2 days | 4 days | 1 | 83068 |  |  | No | Yes
UNHB | [NAME] | WBEDTA | [NAME] EDTA |  |  |  | Refrigerated | 7 days
UNHB | Result | 9095 | Hemoglobin, Unstable, B | Hemoglobin, Unstable, B | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 4639-1 | Hemoglobin.unstable:ACnc:Pt:RBC:[NAME]:
THEVP | [NAME] | SDEX | [NAME], Screen, Blood | [NAME], Scrn, B | [NAME] | EDTA (lavender-top) tube: EDTA |  |  | 1 | mL | Container/Tube: Preferred: Lavender top (EDTA) Acceptable: ACD (solution B), heparin [NAME]: 1 mL  Additional Information: 1. Patient's age is required. 2. Include recent transfusion information. Forms: If not ordering electronically, please submit a Hematopathology/Molecular Oncology Request Form (Supply T241) with the specimen. | 0.5 mL | Hemolysis	Mild OK; Gross reject Thawing	NA Lipemia	NA Icterus	NA Other	NA | Negative Precautions: The procedure does not distinguish hemoglobin S trait from homozygous sickle cell disease nor any of the following combinations: S/C, S/D, S/G, S/E, S/thalassemia, S/O-Arab, S/New York and C-Georgetown trait (Hb C-Harlem). | Monday through Saturday | 1 day | 4 days | 1 | 85660 |  |  | No | Yes
SDEX | [NAME] | WBEDTA | [NAME] EDTA |  |  |  | Refrigerated | 7 days
SDEX | Result | 9180 | [NAME], Scrn, B | [NAME], Scrn, B | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 4621-9 | [NAME]:ACnc:Pt:[NAME]:Ord:
THEVP | [NAME] | IEF | IEF Confirms | IEF Confirms |  | EDTA (lavender-top) tube: EDTA |  |  | 3 | mL |  |  | Hemolysis	NA Thawing	NA Lipemia	NA Icterus	NA Other	NA |  |  |  | 10 days | 1 | 82664 |  |  | No | No
IEF | [NAME] | WBEDTA | [NAME] EDTA |  |  |  | Refrigerated | 10 days
IEF | Result | 81644 | IEF Confirms | IEF Confirms | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 49316-3 | Hemoglobin pattern:Imp:Pt:[NAME]:Nom:Electrophoresis
THEVP | [NAME] | HGBMO | [NAME], Molecular | HGB Electrophoresis, Molecular | Polymerase Chain Reaction (PCR) Analysis/Multiplex Ligation-Dependent Probe Amplification (MLPA), Polymerase Chain Reaction (PCR)/DNA Sequencing (PCR is utilized pursuant to a license agreement with Roche Molecular Systems, Inc.) |  |  |  |  |  | Only orderable as part of a profile. For further information see HBELC/81626 Hemoglobin Electrophoresis Cascade, Blood. |  |  | Only orderable as part of a profile.  For further information see HBELC/81626 Hemoglobin Electrophoresis Cascade, Blood. |  |  |  |  | Profile |  |  | No | No
HGBMO | [NAME] | BLOOD | Whole blood |  |  |  | Refrigerated | 14 days
HGBMO | Component | AGGS | Alpha Globin Gene Mutation Analysis, Direct DNA Sequencing | [NAME] | Only orderable as part of a profile. For further information see #81626 "Hemoglobin Electrophoresis Cascade." |  |  |  |  |  | Only orderable as part of a profile.  For further information see #81626 "Hemoglobin Electrophoresis Cascade." |  |  | Only orderable as part of a profile.  For further information see #81626 "Hemoglobin Electrophoresis Cascade." |  |  |  |  |  |  |  | No | No
AGGS | [NAME] | BLOOD | Whole blood |  |  |  | Refrigerated | 14 days
AGGS | Result | 88997 | [NAME] | [NAME] | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
HGBMO | Component | BGGS | Beta [NAME], Direct DNA Sequencing | Beta [NAME] | Only orderable as part of a profile. For further information see #81626 "Hemoglobin Electrophoresis Cascade." |  |  |  |  |  | Only orderable as part of a profile. For further information see #81626 "Hemoglobin Electrophoresis Cascade." |  |  | Only orderable as part of a profile. For further information see #81626 "Hemoglobin Electrophoresis Cascade." |  |  |  |  |  |  |  | No | No
BGGS | [NAME] | BLOOD | Whole blood |  |  |  | Refrigerated | 14 days
BGGS | Result | 88998 | Beta [NAME] | Beta [NAME] | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 50996-8 | HBB gene mutation analysis:Prid:Pt:Bld/Tiss:Nar:Molgen
HGBMO | Component | MAS | Alpha-Globin Gene Sequence | [NAME] | Only orderable as part of a profile. For further information see #81626 "Hemoglobin Electrophoresis Cascade." |  |  |  |  |  | Only orderable as part of a profile. For further information see #81626 "Hemoglobin Electrophoresis Cascade." |  |  | Only orderable as part of a profile. For further information see #81626 "Hemoglobin Electrophoresis Cascade." |  |  |  | 1 | 81257 |  |  | No | No
MAS | [NAME] | BLOOD | Whole blood |  |  |  | Refrigerated | 14 days
MAS | Result | 89573 | [NAME] | [NAME] | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 21687-9 | [NAME] gene mutation analysis:Prid:Pt:Bld/Tiss:Nom:Molgen
HGBMO | Component | MBS | Beta-Globin Gene Sequence | Beta [NAME] | Only orderable as part of a profile. For further information see #81626 "Hemoglobin Electrophoresis Cascade." |  |  |  |  |  | Only orderable as part of a profile. For further information see #81626 "Hemoglobin Electrophoresis Cascade." |  |  | Only orderable as part of a profile. For further information see #81626 "Hemoglobin Electrophoresis Cascade." |  |  |  | 1 | 81401 |  |  | No | No
MBS | [NAME] | BLOOD | Whole blood |  |  |  | Refrigerated | 14 days
MBS | Result | 89405 | Beta [NAME] | Beta [NAME] | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 50996-8 | HBB gene mutation analysis:Prid:Pt:Bld/Tiss:Nar:Molgen
HGBMO | Component | BGDD | Beta-Globin Gene Deletion/Duplication | Beta [NAME] | Only orderable as part of a profile. For further information see #81626 "Hemoglobin Electrophoresis Cascade." |  |  |  |  |  | Only orderable as part of a profile. For further information see #81626 "Hemoglobin Electrophoresis Cascade." |  |  | Only orderable as part of a profile. For further information see #81626 "Hemoglobin Electrophoresis Cascade." |  |  |  | 1 | 81403 |  |  | No | No
BGDD | [NAME] | BLOOD | Whole blood |  |  |  | Refrigerated | 14 days
BGDD | Result | 89575 | Beta [NAME] | Beta [NAME] | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 21689-5 | HBB gene mutation analysis:Prid:Pt:Bld/Tiss:Nom:Molgen
HGBMO | Component | MDE | DNA Extraction-Purgene Method | Manual DNA Extraction | Only orderable as part of a profile. For further information see #81626 "Hemoglobin Electrophoresis Cascade." |  |  |  |  |  | Only orderable as part of a profile. For further information see #81626 "Hemoglobin Electrophoresis Cascade." |  |  | Only orderable as part of a profile. For further information see #81626 "Hemoglobin Electrophoresis Cascade." |  |  |  | 1 |  |  |  | No | No
MDE | [NAME] | BLOOD | Whole blood |  |  |  | Refrigerated | 14 days
MDE | Result | 29375 | Manual DNA Extraction | Manual DNA Extraction | Alphanumeric
THEVP | [NAME] | MASS | [NAME] by Mass Spectrometry | [NAME] by [NAME], B | Mass Spectrometry (MS) |  |  |  |  |  |  |  |  |  |  |  |  | 1 | 83789 |  |  | No | No
MASS | [NAME] | WBEDTA | [NAME] EDTA |  |  |  | Refrigerated | 10 days
MASS | Result | 60286 | [NAME] by [NAME], B | [NAME] by [NAME], B | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Process
THEVP | [NAME] | AGPBT | Alpha-Globin Gene Analysis | Alpha-Globin Gene Analysis | Dosage Analysis by Polymerase Chain Reaction (PCR)/Multiplex Ligation-Dependent Probe Amplification (MLPA)/Luminex Technology (PCR is utilized pursuant to a license agreement with Roche Molecular Systems, Inc.) |  |  |  |  |  | This test is to be ordered by HemPath only. |  |  | An interpretive report will be provided. | Monday, Wednesday | 8 days | 12 days | 1 | 81404 |  |  | No | Yes (order AGPB)
AGPBT | Result | 31032 | Alpha-Globin Gene Analysis | Alpha-Globin Gene Analysis | Alphanumeric |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 21687-9 | [NAME] gene mutation analysis:Prid:Pt:Bld/Tiss:Nom:Molgen