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Test Code LAB3261 Pernicious Anemia Cascade

Additional Codes

Mayo Test Code: ACASM

Reporting Name

Pernicious Anemia Cascade

Useful For

Diagnosis of pernicious anemia


Diagnosis of vitamin B12 deficiency-associated neuropathy

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
IFBPA Intrinsic Factor Blocking Ab, S Yes, (order IFBA) No
MMAPA Methylmalonic Acid, QN, S Yes, (order MMAS) No
GASTR Gastrin, S Yes, (order GAST) No

Testing Algorithm

If vitamin B12 is <150 ng/L, then intrinsic factor blocking antibody (IFBA) is performed. If IFBA is negative or indeterminate, then gastrin is performed.

If vitamin B12 is 150 to 400 ng/L, then methylmalonic acid (MMA) is performed. If MMA is >0.40 nmol/mL, then IFBA is performed.


See Vitamin B12 Deficiency Evaluation in Special Instructions.

Performing Laboratory

Mayo Medical Laboratories in Rochester

Specimen Type


Specimen Required


Preferred: Red top

Acceptable: Serum gel

Specimen Volume: 4 mL

Collection Instructions:

1. Fasting (8 hours)

2. Divide specimen into 3 plastic vials, 1 containing 1 mL, 1 containing 1.5 mL, and 1 containing 1.5 mL

3. Band specimens together.

Additional Information: This test should not be ordered on patients who have received vitamin B12 injection within the last 2 weeks.

Specimen Minimum Volume

2.3 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Frozen 14 days

Special Instructions

Reference Values

180-914 ng/L

Day(s) and Time(s) Performed

Monday through Friday 5 a.m.-12 a.m.

Saturday 6 a.m.-6 p.m.

CPT Code Information

82607-Vitamin B12 assay

82941-Gastrin (if appropriate)

83921-MMA (if appropriate)

86340-IFBA (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
ACASM Pernicious Anemia Cascade 2132-9


Result ID Test Result Name Result LOINC Value
B12PA Vitamin B12 Assay, S 2132-9

Reject Due To


Mild OK; Gross reject


Mild OK; Gross OK





Method Name

Immunoenzymatic Assay


If not ordering electronically, complete, print, and send a Benign Hematology Test Request Form (T755) with the specimen (