Cryoglobulin, Qualitative With Quantitative Reflex

CPT: 82595. If reflex testing is performed, concomitant CPT codes/charges will apply.
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Test Includes

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

Expected Turnaround Time

4 - 8 days

Related Documents

Specimen Requirements


Serum, prewarmed


3 mL

Minimum Volume

2 mL


Red-top tube (no gel)


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

Patient Preparation

Patient should be fasting.

Causes for Rejection

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

Test Details


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


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.


Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
001594 Cryoglobulin, Ql, Serum, Rflx 12201-0 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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