In December, serum and urine protein electrophoresis testing will be simplified and standardized. The only testing available will be:
Protein electrophoresis, serum, IFE if indicated
Protein electrophoresis, random urine, do IFE if indicated
Protein electrophoresis, 24 hour urine, do IFE if indicated
In addition, on December 5, 2019, a new panel will be added which reflects expert recommendations for first line testing for monoclonal gammopathy, including plasma cell myeloma and most cases of amyloidosis, called “Monoclonal Gammopathy Screen”
Protein electrophoresis, serum, IFE if indicated
Kappa and lambda free light chains
Stand-alone protein electrophoresis and stand-alone immunofixation testing orderables will be discontinued and replaced by the above orderables. This change serves to ensure that the best testing is performed for all patients, especially decreasing unnecessary upfront immunofixation testing and implementing appropriate reflex testing in the laboratory. This approach aligns to the recommendations from multiple societies for screening and follow-up for monoclonal gammopathy. This is similar to the approach utilized by Mayo Medical Laboratories and recommended by Blood and Up to Date algorithms. These changes have been reviewed and approved by the Spectrum Health Medical Executive Committee.
Questions and inquiries may be directed to the Immunochemistry department using the “contact us” link above.
REFERENCES
Ronald S. Go and S. Vincent Rajkumar “How I manage monoclonal gammopathy of undetermined significance” Blood. 2018;131(2):163-173). doi:10.1182/blood-2017-09-807560
TEST INFORMATION
Available testing
Protein Electrophoresis, Serum, IFE if Indicated – Epic #LAB844, Interface #10811, CPT #84165*
Protein Electrophoresis, Random Urine, do IFE if Indicated – Epic #LAB2111445, Interface #11510, CPT #84166*
Protein Electrophoresis, 24 Hour Urine, do IFE if Indicated – Epic #LAB2111444, Interface #11509, CPT #84166*
Kappa and Lambda Free Light Chains – Epic #LAB3114, Interface #11083, CPT #83883 x2
Monoclonal Gammopathy Screen – Epic #LAB1230573, Interface #1230573, CPT 83883 x2, 84165*
Discontinued Testing
Protein Electrophoresis, Serum – Epic #LAB119, Interface #10232, CPT #84165*
Protein Electrophoresis, Random Urine – Epic #LAB438, Interface #10516, CPT #84166*
Protein Electrophoresis, 24 hour Urine – Epic #LAB10156, Interface #10234, CPT #84166*
The following tests will only be available for the Laboratory to order
Immunofixation, Serum – CPT #86334*
Immunofixation, Urine – CPT #86335*
*Additional professional codes for pathologist interpretation may be added
