TEST UPDATE Serum Protein Electrophoresis and Immunofixation

Pranil K. Chandra, DO, Medical Director Jeff Johnson, AVP of Operations

This change will take effect December 2, 2013

OVERVIEW AND CLINICAL UTILITY:

Effective December 2, 2013, PathGroup will implement in-house testing for Serum Protein Electrophoresis (SPEP) and Immunofixation (IFE). Protein electrophoresis is a well-established technique routinely used for the screening of protein abnormalities. The fraction concentrations and the electrophoretic pattern may be characteristic of diseases such as monoclonal gammopathies, nephrotic syndrome, and inflammatory processes associated with infection, liver disease, and autoimmune diseases. Monoclonal gammopathies indicate a clonal expansion of plasma cells or mature B lymphocytes and can include diseases such as multiple myeloma, Waldenstrom’s macroglobulinemia, lymphoproliferative disease, and systemic amyloidosis. Detected electrophoretic abnormalities should be immunotyped to confirm and characterize the monoclonal protein. Immunotyping of monoclonal proteins is usually done by immunofixation electrophoresis (IFE) and identifies the monoclonal immunoglobulin heavy-chain and/or light chain type (kappa or lambda). It is generally recommended that both SPEP and IFE be used as a screening panel. In patients with suspected amyloidosis, a urine immunofixation should be ordered along with the myeloma screening panel.

TEST METHODOLOGY: Quantitative Capillary Electrophoresis, Qualitative Immunofixation Electrophoresis

ORDERING:

PHYSICIAN ORDERS MUST SPECIFY THE REQUEST FOR INTERPRETATION WHEN INCLUSIVE TEST IS ORDERED TEST NAME NEW TEST CODE OLD TEST CODE CPT Myeloma Screening Panel MYSP 84165/84155/84165-26/86334/83883x2

Protein Electrophoresis (Serum) PES PEMRS 84165/84155

Protein Electrophoresis and IFE with PESIFI SPE 84165/ 84155/86344/84165-26 Interpretation

Protein Electrophoresis and IFE PESIF 84165/84155/86334

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TEST NAME NEW TEST CODE OLD TEST CODE CPT Protein Electrophoresis, IFE, 84165/84155/86344/ PESIFE Immunoglobulins /82784x3 Protein Electrophoresis, IFE, PESIFEI 84165/84155/86344/84165-26/82784x3 Immunoglobulins and Interpretation Protein Electrophoresis w/ Reflex to IFE PESRIFE 84165/84155 if reflexed 86344/82784x3 and Immunoglobulins Protein Electrophoresis w/Interpret w/ 84165/84165-26/84155 if reflexed PESRIFEI SPERF Reflex to IFE and Immunoglobulins 86344/82784x3 Protein Electrophoresis w/ Interpret w/ 84165/84165-26/84155 Reflex to IFE, Immunoglobulins & Free PESRIFIL if reflexed 86344/83883x2/82784x3 Light Chains Protein Electrophoresis w/ Reflex to IFE, PESRIFLC 84165 if reflexed 86344/83883x2/82784x3 Immunoglobulins & Free Light Chains

Protein Electrophoresis Interpretation PESINT 84165-26

Immunofixation IFE MOGAM 86334

REFERENCE RANGE:

Refer to Directory of Services (DOS) for updated reference ranges.

SPECIMEN COLLECTION AND STORAGE:

COLLECTION REQUIREMENTS  Collect specimen in a SST. a) Allow serum tube to clot for 30 minutes. b) Spin serum separator tube 10-15 minutes @ 3500 rpm.  Serum specimens are stable refrigerated for 7 days.  Transport specimen refrigerated.  Unacceptable: Hemolysis or Lipemia

TEST PERFORMED: Monday - Friday TURNAROUND TIME: 1 - 4 Days

For further questions, please contact Client Services at 615-562-9300 or 888-474-5227

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