HemoglobinA1c (Waived)

CPT Code: 83036
Specimen: Whole blood
Volume: 4 mL
Minimum Volume: Pediatric EDTA whole blood tubes may be used. Please place the entire tube in a transport tube for shipment to the laboratory.
Container: Lavender-top (EDTA) tube or green-top (lithium heparin) tube. Other anticoagulants have not been tested or found acceptable.
Collection: The usual precautions in the collection of venipuncture samples should be observed. The sample must be free of clots. Samples with any hematocrit disorders can lead to erroneous results. Send the entire tube to the laboratory.
Reference Range:  
Storage: Maintain specimen at room temperature.

Stability:

 

 Use: The A1c test is used to monitor the glucose control of diabetics over time. The goal of those with diabetes is to keep their blood glucose levels as close to normal as possible. This helps to minimize the complications caused by chronically elevated glucose levels, such as progressive damage to body organs like the kidneys, eyes, cardiovascular system, and nerves. The A1c test result gives a picture of the average amount of glucose in the blood over the last few months. This can help the diabetic person and his doctor know if the measures that are being taken to control his diabetes are successful or need to be adjusted.

A1c is frequently used to help newly diagnosed diabetics determine how elevated their uncontrolled blood glucose levels have been over the last 2-3 months. The test may be ordered several times while control is being achieved, and then several times a year to verify that good control is being maintained.

The A1c test may be used to screen for and diagnose diabetes. However, A1c should not be used for diagnosis in pregnant women, people who have had recent severe bleeding or blood transfusions, those with chronic kidney or liver disease, and people with blood disorders such as iron-deficiency anemia, vitamin B12 deficiency anemia, and some hemoglobin variants (e.g., patients with sickle cell disease or thalassemia). In these cases, a fasting plasma glucose or oral glucose tolerance test should be used for screening or diagnosing diabetes.

Elevated Hb A1C may be an indication of diabetes.

 Limitations: Any cause of shortened erythrocyte survival will reduce exposure of erythrocytes to glucose with a consequent decrease in Hb A1c (%). Causes of shortened erythrocyte lifetime might be hemolytic anemia or other hemolytic diseases, homozygous sickle cell trait, pregnancy, or recent significant or chronic blood loss. Glycated Hb F (fetal hemoglobin) is not detected as it does not contain the glycated β chain that characterizes Hb A1c. Specimens containing high amounts of Hb F (>10%) may result in lower than expected Hb A1c.
Causes for Rejection: Clotted specimen