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Test ID: AGPB
Alpha-Globin Gene Analysis

List Fee Provides the Mayo Medical Laboratories list fee for performing the test

$572.60

For amniotic fluid specimens, the following test will be added at an  

additional charge:  

$587.80 for #80334 Amniotic Fluid Culture for Genetic Testing  

 

$1,160.40 = Total List Fee

Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

81257-HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis, for common deletions or variant (eg, Southeast Asian, Thai, Filipino, Mediterranean, alpha3.7, alpha4.2, alpha20.5, and Constant Spring)

 

Amniotic Fluid Culture for Genetic Testing

88235-Tissue culture for amniotic fluid (if appropriate)

88240-Cryopreservation (if appropriate)

 

For nonparticipating payers:

Alpha-Globin Gene Analysis

83891-Isolation or extraction of highly purified nucleic acid

83894-Separation by gel electrophoresis

83900 x 2-Amplification, target, multiplex, first 2 nucleic acid sequences

83909-Separation and identification by high-resolution technique

83912-Interpretation and report

83914 x 15-Mutation identification by enzymatic ligation or primer extension, single segment, each segment

 

Amniotic Fluid Culture for Genetic Testing

88235-Tissue culture for amniotic fluid (if appropriate)

88240-Cryopreservation (if appropriate)