Hemoglobin Electrophoresis

Laboratory Fee Schedule
Procedure #:  BZZ0008A
CPT:  83020, 83021

Synonym(s): Hemoglobinopathy, Hemoglobin Type, or Sickle Cell Screening
Requisition FormG-1B 
Test DescriptionTesting for hemoglobinopathies and thalassemias, including sickle cell anemia.
Pre-Approval NeededN/A
Supplemental Information RequiredN/A
Supplemental Form(s)N/A
Performed on Specimens from (sources)Human
Sample/Specimen Type for TestingDried whole blood on DSHS approved filter paper card.
Minimum Volume/Size RequiredOne ½ inch dried blood spot
Storage/Preservation Prior to Shipping
  • Allow card to dry thoroughly at room temperature in a horizontal position for at least 3 hours. Do NOT allow specimen to touch any surface. 
  • Cover dried specimen with attached flap.
  • Keep specimen away from heat and direct sunlight.
Transport MediumN/A
Specimen Labeling
  • Two patient-specific identifiers required (e.g., patient full name, date of birth, medical record number)
  • Identifiers on specimen must match submission form exactly
Shipping and Specimen Handling Requirements

Ship all specimens according to Dangerous Good Regulations, IATA, and/or CFR 49. 

Must include one completed G1-B form per specimen.   

DRIED FILTER PAPER BLOOD SPECIMENS

  • U.S. Postal regulations require Double containment of dried blood filter paper specimens. Ensure specimens are thoroughly dried prior to placing in envelope.
  • 1st containment: Use the attached wrap-around cover with printed universal biohazard symbol. Do not put biohazard labels on outside of envelope. 
  • 2nd containment:  Place dried filter paper blood specimen in an envelope that is not hermetically sealed. Do not put specimens in plastic bags
  • Ship as soon as possible; within 24hrs of collection. 
  • Avoid temperatures greater than 100°F. 
MethodIsoelectric focusing
Turn-around Time7-10 working days after receipt of specimen
Interferences/LimitationsN/A
Common Causes for Rejection
  • Use of expired specimen collection device
  • No date of collection provided
  • Missing/invalid patient demographic information
  • Specimen is too old upon receipt (received 14 or more days following collection)
  • No blood samples received with request form
  • Insufficient blood has been submitted
  • Specimen is contaminated or discolored
  • Improper specimen submitted (i.e., EDTA whole blood)
  • Serum separation due to improper drying or collection

Visit website for complete list.

Additional InformationAdditional information for specimen collection:
•    View a specimen collection training video for collecting on filter paper