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Specimen Collection Manual and Test Catalog

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MONOCLONAL GAMMOPATHIES SCREENING PANEL

Geisinger Epic Procedure Code:  LAB4833    Geisinger Epic ID:  184923

SPECIMEN COLLECTION
Specimen type: 

Serum. 
Add random urine only if Amyloidosis or Monoclonal Gammopathy of Renal Significance (MGRS) is suspected. See LAB3223 for more information regarding urine specimens.


Preferred collection container: 
Specimen required: 

1.5 mL serum 
If random urine is also collected: 15 mL aliquot AND 5 mL aliquot of urine; minimum 10 mL and 2 mL, respectively.



SPECIMEN PROCESSING
Processing instructions: 

Serum: Allow to clot. Centrifuge and separate serum within 2 hours of collection. Submit 1.5 mL serum. 
Random urine: Do not centrifuge.


Transport temperature: 

Refrigerated (preferred). Room temperature (stable 8 hours) or frozen specimen also acceptable.


Specimen stability: 

Room temperature: 8 hours. Refrigerated (2-8°C): 4 days. Frozen: 3 months.


Rejection criteria: 

Stability limits exceeded; grossly hemolyzed.



TEST DETAILS
Reference interval: 
SPEPFree Light Chains
Albumin: 3.3-4.4 g/dLKappa FLC:3.30-19.40 mg/L
Alpha-1: 0.1-0.3 g/dLLambda FLC: 5.71-26.30 mg/L
Alpha-2: 0.6-1.0 g/dLKappa/Lambda FLC Ratio: 0.26-1.65
Beta: 0.8-1.3 g/dL 
Gamma: 0.7-1.7 g/dL 
Total Protein: 6.0 - 8.3 g/dL 

CPT code(s):  84165, 83521x2. Additional charges if serum immunofixation (Lab3050) and urine immunofixation (Bence Jones protein [LAB3223]) are needed. Please refer to individual test listing for CPT code.
Note: The billing party has sole responsibility for CPT coding.  Any questions regarding coding should be directed to the payer being billed.
The CPT codes provided by GML are based on AMA guidelines and are for informational purposes only.

Test includes: 

Total protein and serum electrophoresis with interpretation and serum free light chains (kappa, lambda, and ratio)


Methodology: 
Electrophoresis
Immunoturbidity
Synonyms: 

Myeloma, MGUS, Amyloidosis, Neuropathy, POEMS, MGRS, Free Light Chain Disease, Monoclonal Gammopathy, Paraprotein panel


Clinical significance: 

When this panel is ordered, serum protein electrophoresis (SPEP) with reflex (LAB3052) and serum free light chains (Lab2567) will be performed. 
If Neuropathy-associated Paraproteinemia is suspected, serum immunofixation (Lab3050) will be added. If Amyloidosis or Monoclonal Gammopathy of Renal Significance (MGRS) is suspected, serum immunofixation (Lab3050) and urine immunofixation (Bence Jones protein [LAB3223]) will be added.


Doctoral Director(s): 
Benjamin Andress, PhD, DABCC
Hoi-Ying Elsie Yu, PhD, DABCC, FADLM
Review Date:  12/12/2024

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