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HelpTest Code MPE Monoclonal Protein Evaluation
Additional Codes
Epic Test ID
LAB2226
Methodology
The Monoclonal Protein Evaluation (MPE), LAB2226 is changing based on recommendations recognized by the College of American Pathologists in collaboration with the American Society of Clinical Pathology, and Association for Diagnostics and Laboratory Medicine.
In the new MPE order set, providers will select one of the following clinical concerns for screening:
- Screen, Standard for Monoclonal Protein
- Screen, Neuropathy
- Screen, AL Amyloid
If Screen, Standard for Monoclonal Protein is selected, an SPEP and SFLC are performed. Reflexive immunosubtraction/immunofixation (IFES) screening will continue to be based on suspicious SPEP findings and/or an abnormal serum free light chain ratio (rSFLC).
If Screen, Neuropathy is selected, an SPEP, SFLC and IFES will be performed.
If Screen, AL Amyloid is selected, an SFLC will be performed at Bronson but SPEP/IFES will be replaced by Mass Spectroscopy (MALDI-TOF MS) send out to Mayo Clinic (Mayo Code: QMPSS), considered the most sensitive test method for amyloidosis screening. Also new with the selection of amyloidosis is the automatic ordering of a UPEP and IFEU to be performed at Bronson.
Performing Laboratory
Bronson Laboratory Services will perform all testing aside from QMPSS which is sent to Mayo Clinic.
Specimen Requirements
If Screen, Standard for Monoclonal Protein or Screen, Neuropathy are selected:
Specimen Type: Serum
Container/Tube: Gold top serum gel-Plain,
red-top tube is also acceptable.
Specimen Volume: 5 mL
Specimen Minimum Volume: 3 mL
If Screen, AL Amyloid is selected:
Specimen Type: Serum
Container/Tube: 2 Gold top serum gel-Plain,
red-top tube is also acceptable.
Specimen Volume: 7 mL
Specimen Minimum Volume: 5 mL
Special instructions: One tube will be used for serum testing performed at BMH the other tube will be used for testing sent to Mayo Clinic. For aliquoting information for send out test to Mayo Clinic, see QMPSS catalog entry.
and
Specimen Type: Urine, 24 hour. Entire collection.
Container/Tube: Clean, plastic urine container
Specimen Volume: 30 mL aliquot from well mixed 24-hour urine.
Collection Instructions:
1. No preservative. Refrigerate specimen during collection.
2. Random urine collection is not acceptable.
Additional Information:
1. 24-Hour volume is required.
2. Starting and ending dates/times of collection are required.
3. Follow instructions in Patient Instructions for 24-Hour Collection under Special Instructions.
Processing Instructions:
1. Measure and record total volume.
2. Mix entire collection well and pour off a 30.0 mL aliquot.
Specimen Transport Temperature
Refrigerate
Reference Values
An interpretive report will be provided.
Day(s) Test Set Up
For serum testing performed at Bronson Laboratory Services - Monday, Wednesday, Friday
For 24 hour urine testing - Tuesday and Thursday
Test Classification and CPT Coding
83883 × 2-Nephelometry
84165-Protein electrophoresis (if appropriate)
Please Note: Additional CPT and professional fee for pathologist’s interpretation may be applied.