Dear Healthcare Provider,

The information contained here may be very important to your practice. Please take a moment to review this document.

NT proBNP Assay Update

August 2021

Alverno Laboratories currently offers an NT proBNP assay for monitoring patients with congestive heart failure (CHF). The NT proBNP assay can be helpful in monitoring patients who are taking Entresto® to treat CHF. Research shows that Entresto®
can interfere with BNP metabolism, while NT proBNP remains a useful cardiac biomarker to assess therapeutic effect and prognosis in patients treated with neprilysin inhibitors.

The NT proBNP assay currently being utilized by Alverno Central Laboratory has recently identified up to a 15% variation in values compared to previously manufactured reagent lots. The variations in values have been seen at the low end of the reference range. Results of this assay should be correlated with the patient’s clinical drug response.

Reference Ranges:
≤ 75 years old: 0 – 124 ng/L
> 75 years old: 0 – 449 ng/L

Specimen Requirements:

Specimen: Whole blood EDTA
Stability: 2 hours ambient, 2 days refrigerated at 2-8°C

SOFT Code: PBNP

Langenickel TH, Dole WP. Angiotensin receptor-neprilysin inhibition with LCZ696: a novel approach for the treatment of heart failure. Drug Discovery Today: Therapeutic Strategies. Vol. 9, No. 4, 2012; e131-e139.

Lung Cancer Panel with KRAS, Reflex to ALK and ROS1
August 16, 2021
Beginning August 16, Alverno’s Molecular Biology Department will offer a reflexive lung cancer panel to replace the current ARUP Lung Cancer with KRAS. Please see page 2 for further details.

Lung Cancer Panel with KRAS, Reflex to ALK and ROS1

August 16, 2021
Beginning August 16, Alverno’s Molecular Biology Department will offer a reflexive lung cancer panel to replace the current ARUP Lung Cancer with KRAS. The new testing algorithm will provide mutation detection in the EGFR and KRAS genes by PCR as the first line of testing. If both EGFR and KRAS testing demonstrate a wildtype (no mutation) status, then reflex testing to ALK and ROS1 by FISH will be performed.

EGFR mutations occur in approximately 10% of non-small cell lung cancers (NSCLC) and are associated with responsiveness to EGFR TKI therapy. The presence of a KRAS mutation is considered a prognostic biomarker suggesting a poor survival outcome for patients with NSCLC and associated with reduced responsiveness to EGFR TKI therapy. Because EGFR, KRAS, ROS1 and ALK mutations do not usually overlap, the reflexive algorithm provides a more targeted approach to testing.

Ordering Information
Testing is requested through the pathologist on the case. The pathologist will submit the AP Request.

Specimen Requirements

Specimen: FFPET – formalin-fixed, paraffin-embedded NSCLC tissue
Stability: Room temperature (15-30°C) indefinitely; 5 micron sections mounted on slides may be stored at 15-30°C for up to 60 days.

Cause for Rejection: Absence of tumor cells

CPT Code: 81275; 81276; 81235, 88381 x2 if reflexed to ALK and ROS1, add 88377 x2

Drugs of Abuse Screening

Update: August 12, 2021
Alverno Laboratories is pleased to announce that we will be updating our Drugs of Abuse panels to analyze at a cutoff level more suitable for clinical testing. The updates will provide a lower level of detection for the Opiates assay at 300ng/mL. The drug panels affected by the updates are provided in the table below.

Drugs of Abuse Panels with 300 ng/mL Opiate Cutoff

• Drug of Abuse Panel 5 with Confirmation – D5WC
• Drug of Abuse Panel 5 without Confirmation – D5WOC
• Drug of Abuse Panel 8 with Confirmation – D8WC
• Drug of Abuse Panel 8 without Confirmation – D8WOC
• Drug of Abuse Panel 9 with Confirmation – D9WC
• Drug of Abuse Panel 9 without Confirmation – D9WOC
• Drug of Abuse Panel 9A with Confirmation – D9AWC
• Drug of Abuse Panel 9A without Confirmation – D9AOC
• Drug of Abuse Screen – DOA

Specimen Requirements

Specimen: Urine, 10 mL
Stability: Up to 7 days refrigerated
Method: Immunoassay
Availability: Testing performed as received
CPT: 80307*

Information regarding Soft order codes and CPT codes* can be found on our website, www.AlvernoLabs.com, or by calling 800-937-5521.

*CPT codes provided are for informational purposes only. Questions regarding coding should be directed to the payer.