Hexosaminidase A & Total, Serum

Centralized Core Laboratory : Chemistry

PATIENT INFO

Patient Name:

Medical Record #:

BD: / / Sex: F M

PHYSICIAN INFO

Physician Name :

Address:

Ph: ( ) - Fax: ( ) -

Additional Report to:

Ph: ( ) - Fax: ( ) -

TESTS REQUESTED
Test Name:	ICD9 Code: (required)
1. Hexosaminidase A & Total, Serum
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

HEXAS MAYO

Specimen Type:

Blood

Tube Type:

Red top (no anticoagulant) tube

Collection Volume:

2.5 mL (minimum 1.5 mL)

Cause for Rejection:

Specimen rejected: Grossly icteric.

Storage:

Frozen

Availability:

Sent to reference lab

Methodology:

Heat Activation, Fluorometric, Automated

Special Instructions:

Serum assay results are not valid on pregnant females and will not be run. If carrier screening for Tay-Sachs or Sandhoff disease is desired in a pregnant female and testing was not performed prior to pregnancy, referto NAGR / Hexosaminidase A and Total, Leukocytes/Molecular Reflex or NAGW/ Hexosaminidase A and Total Hexosaminidase, Leukocytes for testing on the patient or partner. The recommended test for Tay-Sachs carrier screening (regardless of gender or pregnancy status) is NAGR / Hexosaminidase A and Total, Leukocytes/Molecular Reflex. Please have patient fill out the Mayo Medical Laboratories' Tay-Sachs Disease Prevention Program Questionnaire. Pregnant females can't be tested. It is suggested that the baby's father be tested for carrier status. If father is a positive carrier, the pregnant female should have Hexosaminidase A & Total Leukocytes. For Outpatients, test should only be drawn in outpatient locations within a Hospital (Akron or Beeghly).

Lab/Phone:

330-543-8418

TAT:

8-15 days

Additional Info:

Reference range is available on patient report

CPT Code:

83080x2