Cryoglobulin, Qualitative With Quantitative Reflex

CPT: 82595. If reflex testing is performed, concomitant CPT codes/charges will apply.
Updated on 8/10/2018
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Test Details

Test Includes

Qualitative test for cryoglobulin; reflex quantitation (as percentage) and immunofixation of cryoprecipitate if positive

Use

Cryoglobulins may be present in macroglobulinemia of Waldenström, myeloma, chronic lymphocytic leukemia, lupus, chronic active hepatitis, and other viral infections.

Methodology

Visual observation of refrigerated samples

Reference Interval

None detected (positives are reported as percentages)

Additional Information

These are proteins that precipitate from blood at low temperatures. A precipitate from serum that forms overnight at 4°C and dissolves at 37°C is called a cryoglobulin.

Cryoglobulins may be divided into three classes. Type I are monoclonal immunoglobulins and are usually associated with lymphoproliferative disorders. Type II are mixtures of a monoclonal IgM and polyclonal IgG, and are associated with macroglobulinemia and chronic active hepatitis. Type III are mixtures of polyclonal IgM and polyclonal IgG. These are found in a wide variety of disorders.

A high percentage of patients with cryoglobulinemia have clinical symptoms, and of these the most common are vascular (ie, purpura and digital necrosis). Raynaud phenomenon is also common.

Patients with SLE who are rheumatoid factor-negative but cryoglobulin-positive are more likely to develop renal disease than those who are rheumatoid factor-positive and cryoglobulin-negative.

Specimen Requirements

Specimen

Serum

Volume

3 mL

Minimum Volume

2 mL

Container

Red-top tube
Red-top tube or gel-barrier tube
Red-top tube tube

Patient Preparation

Patient should be fasting.

Collection

Specimen must be drawn in a prewarmed tube and kept at 37°C while clotting. Separate serum from cells immediately after clot formation (keep at 37°C while clotting), and transfer serum into a clean transport tube. Label transport tube "Prewarmed."

Storage Instructions

Room temperature

Causes for Rejection

Specimen not allowed to clot at 37°C; patient not fasting; lipemia; gel-barrier tube used for collection

Specimen not allowed to clot at 37°C; patient not fasting; lipemia

Specimen not allowed to clot at 37°C; patient not fasting; lipemia; gel-barrier tube used for collection

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
001594 Cryoglobulin, Ql, Serum, Rflx 001595 Cryoglobulin, Ql, Serum, Rflx 12201-0
Reflex Table for Cryoglobulin, Ql, Serum, Rflx
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 001686 Immunofixation Elect 001681 Cryoglobulin % % 15174-6
Reflex Table for Cryoglobulin, Ql, Serum, Rflx
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 001686 Immunofixation Elect 001684 IFE Result, Cryoprecipitant 48638-1

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The LOINC® codes are copyright © 1994-2018, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. Permission is granted in perpetuity, without payment of license fees or royalties, to use, copy, or distribute the LOINC® codes for any commercial or non-commercial purpose, subject to the terms under the license agreement found at https://loinc.org/license/. Additional information regarding LOINC® codes can be found at LOINC.org, including the LOINC Manual, which can be downloaded at LOINC.org/downloads/files/LOINCManual.pdf