Kappa/Lambda Light Chains, Free with Ratio, Urine [11233X]

Test Code

Alias/See Also

CPT Codes
83883 (x2)

Preferred Specimen
2 mL of a random urine collected in a plastic, leak-proof container

Minimum Volume
1 mL

Other Acceptable Specimens
Unpreserved 24-hour urine collection

Transport Temperature
Room temperature

Specimen Stability
Room temperature: 7 days
Refrigerated: 21 days
Frozen: 90 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Gross hemolysis • Lipemic specimen


Setup Schedule
Set up: Mon-Sat p.m.; Report available: Next day

Reference Range
Kappa Light Chain, Free, Urine 1.35-24.19 mg/L
Lambda Light Chain, Free, Urine 0.24-6.66 mg/L
Kappa/Lambda Light Chains Free with Ratio, Urine 2.04-10.37

Clinical Significance
This test is a latex-enhanced, immunoassay that provides ultrasensitive detection and quantitation of free light chains (FLCs) in serum or urine earlier than electrophoresis. It is an aid in the diagnosis and treatment of multiple myeloma, lymphocytic neoplasms, Waldenstroms macroglobulinemia, and connective tissue diseases, such as systemic lupus erythematosus.

Approximately 15% of all cases of multiple myeloma produce only free kappa or lambda light chains in excess. These patients frequently show no abnormality on serum protein electrophoresis. Quite often urine is tested for the presence of these light chains, which are also called Bence Jones Proteins. However, the FLCs entering the urine are strongly influenced by renal tubular function. When clonal proliferation of plasma cells starts to develop, the FLC concentration increases in serum. Since these small particles are rapidly cleared by the renal tubules, urine tests for FLCs remain negative until the tumor mass expands, and the FLCs in serum exceed the resorptive capacity of the renal tubules. Therefore, the measurement of FLCs in serum is an alternative to less sensitive urine testing. Changing concentrations of FLCs in serum relate better to changing tumor load than to concentrations in urine.

Performing Laboratory
Quest Diagnostics Nichols Institute
14225 Newbrook Drive
Chantilly, VA 20153

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.