Cryoglobulin Screen with Reflex to Cryoglobulin Panel

Message
*Draw 2 plain red top tubes. Keep tubes warm in a heal warmer and bring to processing ASAP.
*Collect specimen Monday through Friday only before 1600 EST. Do not collect the day before a holiday.


Test Code
37358


Alias/See Also
LAB713


CPT Codes
82595

Includes
If cryoglobulin is present (positive), it is identified. Positives are semi-quantitated (as % cryoglobulin) by cryocrit.
If Cryoglobulin Screen is positive, then Cryoglobulin Panel (Cryocrit Immunofixation, Cryocrit Immunodiffusion and Rheumatoid Factor) will be performed at an additional charge (CPT Code(s): 86334, 86329, 86431).


Preferred Specimen
10 mL serum collected in a red-top tube (no gel)


Patient Preparation
Overnight fasting is required

Minimum Volume
3.5 mL


Instructions
Collect 20 mL of fasting whole blood specimen in a red-top tube (no gel). 10 mL serum required; 3.5 mL minimum. Avoid hemolysis.

Allow serum sample to clot for one (1) hour in a 37° C water bath, oven, incubator, or heat block. After clotting, centrifuge the specimen for 10 minutes at 1600 RCF(G) utilizing one of the 3 options below:
1. In a "warm" centrifuge at 37° C
2. In a bench-top centrifuge placed in a "warm room" at 37° C
3. At room temperature, in a bench-top centrifuge prewarmed by running it for 10 minutes at 1600 RCF(G).
After centrifuging, decant serum into a screw-capped vial. Transport at room temperature.

Note: No other tests can be added to the tube; Cryocrit and Cryoglobulin evaluation only.


Transport Container
Transport tube(s)


Transport Temperature
Room temperature


Specimen Stability
Room temperature: 72 hours
Refrigerated: Unacceptable
Frozen: Unacceptable


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Gross hemolysis • Grossly lipemic • Icteric • Serum separator tube (SST)


Methodology
Cryocrit • Electrophoresis • Immunodiffusion (ID) • Immunofixation (if needed) • Rate Nephelometry

FDA Status
This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Setup Schedule
Sun-fri


Reference Range
Cryoglobulin, QL Negative in normal individuals


Clinical Significance
Cryoglobulins are proteins that precipitate from serum at temperatures below 37° C. Most precipitate when serum is cooled at 4° C, but some gel even at room temperature. The gel or precipitate must redissolve at 37° C to be classified as a cryoglobulin.


Performing Laboratory
Quest Diagnostics Nichols Institute-San Juan Capistrano, CA
33608 Ortega Highway
San Juan Capistrano, CA 92675-2042




The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.