Which patient characteristics increase the diagnostic yield of A1AT level testing in newly diagnosed cirrhosis, and when should phenotyping be performed in addition to measuring levels?

We have issues with getting phenotypes paid for by Medicare and Medicaid, so I often send a level first. If the level is below 80 mg/dL, then I send the phenotype. Also, concern is raised in patients with FH of cirrhosis or emphysema, or the patient does not have other obvious risk factors for cirrh...