2016
Proficiency Testing
Catalog
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for MLE updates:
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Approved by: CMS, COLA, TJC, U.S. State Agencies
and International regulatory bodies.
CAP accepted analytes offered.
MLE is already known for providing prompt, courteous service to all
of our customers; but now we are excited to provide the best-inclass customer service experience with personalized care from the
beginning to the end of your ordering process.
MLE’s
White Glove
Concierge Service
Our White Glove Concierge Service
will provide:
• Responses to your calls within two hours
(during normal business hours)
• Affordable test packages
• Assistance in choosing the appropriate test
modules for your instrumentation
• Verification of orders within one week
• Analysis of your reported analyte test menu for
CLIA compliance.
• Assistance in your entire process from
ordering to submission
• Auto renewal of customers with their previous
year’s orders upon request
As an extra special touch, our expert concierge
team is responsible for your overall accounts and
will be at your side from ordering to submission by
assisting in your entire proficiency testing process.
Rest assured, with our expert concierge team on
the job, you can leave the worry to us.
From your White Glove Concierge Team
1-800-338-2746, option 5
[email protected]
www.acponline.org/mle
2016 SHIP DATES M1: Feb. 1 • M2: May 16 • M3: Sept. 12
Table of Contents
At a Glance
Overview
Customer Service Hours and Contact
Information
Overview/How MLE Works . . . . . . . . . . . . . . . . . . . . . . . . . .4
Monday through Friday from 9:00 a.m. to 5:00 p.m. ET
Test Index and Module Descriptions
Telephone: 1-800-338-2746, option 5
Test Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-3
E-mail: [email protected]
(See pages 16 and 17 for CAP Accepted Analytes listing)
Fax: 202-835-0440
Hematology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
Web: www.acponline.org/mle
Blood Bank . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Coagulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Provider-Performed Microscopy (PPM) . . . . . . . . . . . . . . . .6
Enrollment/Renewal of Proficiency Testing
Enroll early to ensure the availability of specimens for the
Urinalysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
2016 program year. Once we process your order, you will be
Microbiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
mailed an order verification for your review and signature.
Immunology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Chemistry
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
Waived Testing
Online Order Form: Visit www.acponline.org/mle. Click
on the “Enrollment Information” link. Complete the
appropriate electronic order form to automatically calculate
pricing, and you will receive an order summary page.
“E-Notification” of Waived Devices and Recalls . . . . . . . . .14
MLE PT Order Form: Detach the order form on page 24,
complete it and fax it. (If submitting a purchase order,
please fax.)
Supplies & Services . . . . . . . . . . . . . . . . . . . . . . . . . .15
Fax: 202-835-0440.
Automatic Renewal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15
Continuing Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15
Online Result Reporting . . . . . . . . . . . . . . . . . . . . . . . . . . .15
Off-Schedule Testing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15
CAP Accepted Analytes
. . . . . . . . . . . . . . . . . .16, 17
Ordering and Discounts
MLE DISCOUNT OFFERS . . . . . . . . . . .Inside Back Cover
Mail:
Mailing Form with Payment
Mailing Form w/o Payment
AC003
American College of Physicians
190 N. Independence Mall West
Philadelphia, PA 19106-1572
ACP/MLE
Suite 700
25 Massachusetts Ave. NW
Washington, DC 20001-7401
Method of Payment
Enrollments received by renewal form or order form will be
Price Match Service . . . . . . . . . . . . . . . . . . . . . . . . .19, 20, 21
invoiced within one week of activation. Auto Renewals will
How to Order/Ordering Instructions . . . . . . . . . . . . . . . . .22
be invoiced in early October. Invoices are due within 30
FAQ
days. Payment options include credit card (Mastercard or
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
Order Changes/Cancellations . . . . . . . . . . . . . . . . . . . . . . .18
Visa), purchase order, or check. Overdue accounts are
Price List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23
subject to holds and/or cancellations.
Proficiency Testing Order Form . . . . . . . . . . . . . . . . . . . . .24
Off-Schedule Proficiency Testing
Provides laboratories with an option for immediate, ondemand proficiency testing, a complement to the regular
Save Money!—Price Matching for
Unmatched Service
Found a lower price? We’ll match it!
Complete the MLE Price Match Request Form
(pages 20-21), listing only the tests you
actually perform. If our prices aren’t the lowest,
we’ll match our competitor’s quote for the same
total test menu coverage.
scheduled proficiency testing. For more details on this
service, see page 15.
Educational Resources
For a listing of Educational Resources, including the G2
NIR publication, please see our web site at:
www.acponline.org/running_practice/mle/edu_cat.htm
Medical Laboratory Evaluation 2016
www.acponline.org/mle
1
2016 SHIP DATES M1: Feb. 1 • M2: May 16 • M3: Sept. 12
Test Index
CMS regulated analytes for CLIA purposes are in
bold type.
ABO Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Acetaminophen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Acetone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Affirm VPIII (DNA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Albumin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 12
Alcohol, Serum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Alkaline Phosphatase . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 12
Allergy Testing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
Alpha-fetoprotein (AFP) . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
ALT (SGPT) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 12
Ammonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Amylase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 12, 14
Anti-dsDNA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
Anti-HAV (IgM) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
Anti-HAV (Total/IgG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
Anti-HBc (IgM) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
Anti-HBc (Total/IgG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
Anti-HBs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
Anti-HCV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
Anti-HIV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
Waived methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
Anti-RNP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
Anti-RNP/Sm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
Anti-SSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
Anti-SSA/SSB . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
Anti-SSB . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
Anti-Sm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
Anti-Streptolysin O (ASO) . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Antibody Identification . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Antimicrobial Susceptibility Testing . . . . . . . . . . . . . . . . .8
Antinuclear Antibody (ANA) . . . . . . . . . . . . . . . . . . . . . . . .10
Apolipoprotein A1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Apolipoprotein B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
AST (SGOT) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 12
Beta (b)-2 Microglobulin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Bilirubin, Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 12
Bilirubin, Direct . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12, 13
Bilirubin, Neonatal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Blood Cell Identification . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
Blood Culture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
Blood Gases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Blood Smear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
BNP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
C-Peptide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
CA 125 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
CA 15-3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
CA 19-9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
CA 27/29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Calcium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 12, 14
Calcium, Ionized . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 13
Candida, Affirm VPIII(DNA) . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Carbamazepine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
CEA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
C. difficile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Chlamydia (EIA/DNA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
2
www.acponline.org/mle
Chloride . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 12, 13, 14
Cholesterol, Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 12
CK-MB . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
CO2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 12
Colony Count . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
Compatibility Testing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Complement C3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
Complement C4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
Cortisol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
C-Reactive Protein (CRP) . . . . . . . . . . . . . . . . . . . . . . . . . . .9, 10
C-Reactive Protein, high sensitivity (HS-CRP) . . . . . . . . . . . .10
Creatine Kinase (CK) . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 12
Creatinine, Serum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 12
Creatinine, Urine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7, 14
Crossmatch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Cryptosporidium, Antigen Detection . . . . . . . . . . . . . . . . .9
Crystal Screening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
CSF Culture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
D-Dimer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Dermatophyte Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
DHEA-S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Differential, Automated . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
Digoxin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Drug Screen, Urine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
Eosinophils, Nasal (PPM) . . . . . . . . . . . . . . . . . . . . . . . . .6, 7, 15
Estradiol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Fecal Leukocytes (PPM) . . . . . . . . . . . . . . . . . . . . . . . . . .6, 7, 15
Fecal Occult Blood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7, 15
Fecal Suspension, parasitology . . . . . . . . . . . . . . . . . . . . . .9
Fern Testing (PPM) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6, 7, 15
Ferritin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Fibrinogen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Fluid Cell Count . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Folate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Fructosamine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
FSH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Gardnerella, Affirm VPIII (DNA) . . . . . . . . . . . . . . . . . . . . .9
GC (EIA/DNA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Genital Culture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8, 9
Gentamicin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
GGT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 12
Giardia lamblia, Antigen Detection . . . . . . . . . . . . . . . . . .9
Glucose, serum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 12
Waived methods . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 11, 14, 15
Whole blood methods . . . . . . . . . . . . . . . . . . . . . . . .5, 7, 14, 15
Glucose, urine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
Glycohemoglobin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Gram Stain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8, 9
Gram Stain Morphology . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8, 9
HBeAg . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
HBsAg . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
hCG, serum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
hCG, urine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7, 15
HDL Cholesterol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 12
Hematocrit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 11
Waived methods . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 7, 11, 15
Hemoglobin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 11
Waived methods . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 7, 11, 15
Hemoglobin A1C (Glycohemoglobin) . . . . . . . . . . . . . . . . . . . .13
Homocysteine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
H. pylori, Antibody Detection . . . . . . . . . . . . . . . . . . . . . . . . . .11
Medical Laboratory Evaluation 2016
2016 SHIP DATES M1: Feb. 1 • M2: May 16 • M3: Sept. 12
i-STAT Chemistry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
Waived cartridge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
IgA, Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
IgE, Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
IgG, Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
IgM, Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
Infectious Mononucleosis . . . . . . . . . . . . . . . . . . . . . . . . .9, 10
Waived methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
Influenza A, Antigen Detection . . . . . . . . . . . . . . . . . . . . . . .9
Waived methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Influenza B, Antigen Detection . . . . . . . . . . . . . . . . . . . . . .9
Waived methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Influenza A/B Combo, Antigen Detection . . . . . . . . . . . . . .9
Waived methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
INR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Insulin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Iron . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
KOH Vaginal Prep (PPM) . . . . . . . . . . . . . . . . . . . . . . . . .6, 7, 15
KOH Skin Prep (Slides) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7, 9
Lactic Acid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12, 13
LDH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
LDL Cholesterol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 12
Lead, Blood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Waived methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Legionella, Antigen Detection . . . . . . . . . . . . . . . . . . . . . . . .9
LH
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Lipase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Lithium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Lyme Disease Serology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
Magnesium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12, 14
Microalbumin, quantitative . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
Microalbumin, urine dipstick . . . . . . . . . . . . . . . . . . . . . . . . . . .7
MRSA Screening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Mycoplasma, IgG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
Myoglobin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Nasal Eosinophils (PPM) . . . . . . . . . . . . . . . . . . . . . . . . .6, 7, 15
NT-proBNP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Occult Blood, Fecal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7, 15
Osmolality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
Parasitology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Parathyroid hormone (PTH) . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Partial Thromboplastin Time (APTT) or (PTT) . . . . . . . .6
pCO2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
pH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Phenobarbital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Phenytoin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Phosphorus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 12, 14
Pinworms (PPM) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6, 7, 15
Platelet Count . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
pO2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Potassium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 12, 13, 14
Progesterone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Prolactin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Protein, Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 12, 14
Prothrombin Time (PT) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Whole blood methods (non-waived) . . . . . . . . . . . . . . . . .6
Waived methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Provider-Performed Microscopy (PPM) . . . . . . . . . . . . . .6, 7, 15
PSA, Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
PSA, Free . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
PVA Slide, parasitology . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Red Blood Cell Count . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 6
Medical Laboratory Evaluation 2016
Respiratory Culture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
Reticulocyte Count . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
Rheumatoid Factor (RA) . . . . . . . . . . . . . . . . . . . . . . . . .9, 10
Rh Factor (D Type) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Rotavirus, Antigen Detection . . . . . . . . . . . . . . . . . . . . . . . .9
RSV, Antigen Detection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Waived methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Rubella, IgG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
Salicylate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Scabies (PPM) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6, 7, 15
Sedimentation Rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 6
SHBG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Sodium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 12, 13, 14
Sperm (PPM) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6, 7, 15
Stool Culture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
Strep A, Antigen Detection . . . . . . . . . . . . . . . . . . . . . . . . . .8
Waived methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7, 8, 15
Strep pneumoniae, Antigen Detection . . . . . . . . . . . . . . . .9
Syphilis Serology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
T3, Free . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
T3, Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
T3, Uptake . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
T4, Free . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
T4, Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
tCO2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
Testosterone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Testosterone, Bioavailable . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Testosterone, Free . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Theophylline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Throat Culture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
Thyroglobulin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Thyroglobulin antibody . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Thyroid Microsomal antibody . . . . . . . . . . . . . . . . . . . . . . . . . .13
TIBC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Transferrin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Trichomonas, Affirm VPIII (DNA) . . . . . . . . . . . . . . . . . . . . . . .9
Triglyceride . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 12
Troponin I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Troponin T . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
TSH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
UIBC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Unexpected Antibody Detection . . . . . . . . . . . . . . . . . . . . . .6
Urea Nitrogen (BUN) . . . . . . . . . . . . . . . . . . . . . . . . .11, 12, 14
Uric Acid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 12, 14
Urine Chemistry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
Urine Culture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
Urine Dipstick . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7, 15
Urine Drug Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
Urine hCG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7, 15
Urine Sediment Identification . . . . . . . . . . . . . . . . . . . . . . .7, 15
Valproic Acid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Vancomycin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Vitamin B12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Vitamin D, 25-Hydroxy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Waived and PPM packages . . . . . . . . . . . . . . . . . . . . . . . . . .7, 15
Wet Mount Preparations (PPM) . . . . . . . . . . . . . . . . . . . .6, 7, 15
White Blood Cell Count . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 6
Wound Culture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
www.acponline.org/mle
3
2016 SHIP DATES M1: Feb. 1 • M2: May 16 • M3: Sept. 12
Overview
An essential tool for quality improvement, Proficiency Testing (PT) was originally developed as an educational tool to help
laboratories investigate internal procedural problems and take corrective action to minimize the effect on patient results.
Today, PT is the standard of competency most heavily weighed by regulatory inspectors. MLE’s Proficiency Testing (PT)
program is designed for easy access, simple performance, and clear reporting.
PT is the practice of testing specimens of unknown values sent from an outside source. After submitting your test results, you receive
data that compare your laboratory’s performance with that of other labs that did the same procedures on the same specimens.
All tests in the MLE Program are included in the same shipment. Ordering information and instructions start on page 18.
Our Guarantee
If a specimen is missing, leaking, broken, not labeled, hemolyzed, or crushed, and you contact
us within three (3) working days of receipt of your kit, we will provide a replacement for the
specimen(s) FREE of charge (limited to material availability) or your lab will receive a grading
exception for that test.
H o w M L E Wo r k s
1
2
3
4
5
6
7
8
MLE
Catalog
Order
Form
Order
Verification
Program
Binder
Kit
Shipments
Test
Completion
Data
Processing
Evaluation
Distribution
1 MLE sends you a catalog to review ordering
options.
2 You complete an online or hard copy order form
(page 24) and return it to MLE for processing.
3 MLE processes your order and sends you
an Order Verification for your review and
approval. This is your proof of enrollment.
4 Approximately four weeks prior to the
upcoming shipment, MLE sends you a program
binder to prepare for your first testing event.
4
www.acponline.org/mle
5 MLE sends you scheduled shipments of test kits
that include specimens to analyze in the same
way that you regularly test patient specimens.
6 Upon completion of the testing, you submit
your results online or mail to MLE for evaluation.
7 MLE performs statistical compilation of all
participants’ results.
8 MLE mails or e-mails you an evaluation report,
graded according to regulatory requirements,
that compares your performance with that of
other laboratories that used similar methods
and instruments.
Medical Laboratory Evaluation 2016
2016 SHIP DATES M1: Feb. 1 • M2: May 16 • M3: Sept. 12
Hematology
225 Hematology with 3-part Differential . . . . . . . . . .$282
Note: Module descriptions within each category are NOT listed
in numerical order. They are grouped by the type of test.
Please pay close attention to instrument
compatibility notes when selecting
hematology modules.
210 Hematology Module . . . . . . . . . . . . . . . . . . . . . .$240
Includes 211 and 230.
Platelet Count
Red Blood Cell Count
White Blood Cell Count
211 Basic Hematology . . . . . . . . . . . . . . . . . . . . . . . .$228
Five challenges each.
Hematocrit
Hemoglobin
Platelet Count
Five challenges each.
Automated Differential
Hematocrit
Hemoglobin
Questions? Contact MLE Customer Service.
See “Hematology Instrument List” online at
www.acponline.org/running_practice/mle/
enroll_us.htm
Blood Cell Identification
Hematocrit
Hemoglobin
Compatible with most 3-part differential instruments.
Sysmex users see 224.
Red Blood Cell Count
White Blood Cell Count
212 Hemoglobin/Hematocrit . . . . . . . . . . . . . . . . . . .$204
Five challenges each.
213 Hemoglobin/Hematocrit—Waived . . . . . . . . . . . .$147
For waived methods only.
226 Hematology with 5-part Differential . . . . . . . . . .$330
Compatible with most Beckman–Coulter 5-part
differential instruments EXCEPT for the AcT 5diff
(see 228).
Five challenges each.
Automated Differential
Hematocrit
Hemoglobin
Platelet Count
Red Blood Cell Count
White Blood Cell Count
228 Hematology with 5-part Differential . . . . . . . . . .$330
Compatible with Beckman Coulter AcT 5diff and ABX
Pentra 5-part differential instruments.
Five challenges each.
Automated Differential
Hematocrit
Hemoglobin
Platelet Count
Red Blood Cell Count
White Blood Cell Count
229 Sysmex with 5-part Differential . . . . . . . . . . . . . .$330
Compatible with most Sysmex 5-part differential
instruments only.
Five challenges each.
Automated Differential
Hematocrit
Hemoglobin
Two challenges each.
Platelet Count
Red Blood Cell Count
White Blood Cell Count
Platelet Count
Red Blood Cell Count
White Blood Cell Count
215 Hemoglobin/Glucose . . . . . . . . . . . . . . . . . . . . . .$156
230 Blood Cell Identification (Add-On) . . . . . . . . . . . .$36
For HemoCue only.
Same as 231.
Two challenges each.
Only available with 223 through 229.
223 Hematology with 5-part Differential . . . . . . . . . .$330
Compatible with most Abbott CELL-DYN 5-part
differential instruments only.
Five challenges each.
Automated Differential
Hematocrit
Hemoglobin
Platelet Count
Red Blood Cell Count
White Blood Cell Count
224 Sysmex with 3-part Differential . . . . . . . . . . . . . .$273
Compatible with Sysmex 3-part automated differential
instruments only.
Stand-alone module.
Five challenges consisting of color
photographs.
240 Reticulocyte Count . . . . . . . . . . . . . . . . . . . . . . .$210
Compatible with automated and manual reticulocyte
counting methods. Not for use with brilliant cresyl
blue staining methods.
Two challenges.
247 Sedimentation Rate . . . . . . . . . . . . . . . . . . . . . . .$168
Five challenges each.
Automated Differential
Hematocrit
Hemoglobin
231 Blood Cell Identification . . . . . . . . . . . . . . . . . . .$108
Platelet Count
Red Blood Cell Count
White Blood Cell Count
Medical Laboratory Evaluation 2016
Not for use with Sedimat 15 / 15 Plus
Two challenges.
*Sedimentation Rate is not required by CAP.
CAP accepted analytes
www.acponline.org/mle
5
2016 SHIP DATES M1: Feb. 1 • M2: May 16 • M3: Sept. 12
248 Sedimat 15 ESR . . . . . . . . . . . . . . . . . . . . . . . . . .$168
Compatible with the Polymedco Sedimat 15 / 15 Plus
instruments only.
Two challenges.
324 Roche CoaguChek XS INR . . . . . . . . . . . . . . . . $174
Two challenges.
INR
328 i-STAT Prothrombin Time . . . . . . . . . . . . . . . . . . .$333
*Sedimentation Rate is not required by CAP.
250 Fluid Cell Count/Crystals . . . . . . . . . . . . . . . . . . .$183
Fluid for Hemocytometer cell count and color photographs for identification of crystals.
Compatible with the i-STAT instruments only.
Five challenges each.
INR
Prothrombin Time
330 CoaguChek XS Plus Prothrombin Time . . . . . . . .$285
Two challenges each.
Crystal Screening
RBC Count
WBC Count
For CoaguChek XS Plus only.
Five challenges each.
INR
Blood Bank
Prothrombin Time
331 CoaguChek XS Plus Prothrombin Time—Waived $174
For CoaguChek XS Plus only.
450 Rh Factor (D Type) . . . . . . . . . . . . . . . . . . . . . . . .$237
For Slide Methods ONLY.
Two challenges each.
INR
Prothrombin Time
Five challenges.
451 ABO & Rh Factor (D Type) . . . . . . . . . . . . . . . . . .$276
Not for use with slide methods.
Five challenges each.
452 Blood Bank 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . .$378
Not for use with slide methods.
Provider-Performed
Microscopy
Five challenges each.
ABO Group
Rh Factor (D Type)
Unexpected Antibody Detection
453 Blood Bank 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . .$396
Not for use with slide methods.
Five challenges each.
ABO Group
Antibody Identification
Compatibility Testing
(Crossmatch)
Rh Factor (D Type)
Unexpected Antibody
Detection
Coagulation
534 Provider-Performed Microscopy (PPM) . . . . . . . .$114
Color photographs depicting microscopic fields for the
examination of:
Fecal Leukocytes (M2,M3)
FERN testing (M1,M3)
Nasal Eosinophils (M1,M2,M3)
Pinworms (M1,M2)
Scabies (M1,M2)*
Sperm (M2,M3)
Vaginal KOH Preparations (M1,M3)
Vaginal Wet Mount Preparations (M1,M2,M3)
Six challenges total per shipment as
indicated in parentheses above.
*Scabies examination is not required by CAP.
320 Coagulation Module . . . . . . . . . . . . . . . . . . . . . .$189
Requires 1-mL pipette (see item 121 on page 15).
Same as 534. Only available with 530, 531, 532, 541.
Five challenges each.
Fibrinogen
INR
535 Provider-Performed Microscopy (PPM)—Add-On ..$33
Partial Thromboplastin Time
Prothrombin Time
321 Prothrombin Time . . . . . . . . . . . . . . . . . . . . . .$180
Requires 1-mL pipette (see item 121 on page 15).
538 KOH Slides . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$153
Two fixed glass slides for determining the presence or
absence of fungal elements in skin scrapings.
Two challenges.
Five challenges each.
INR
6
Prothrombin Time
www.acponline.org/mle
CAP accepted analytes
Medical Laboratory Evaluation 2016
2016 SHIP DATES M1: Feb. 1 • M2: May 16 • M3: Sept. 12
Urinalysis
542 Fecal Occult Blood . . . . . . . . . . . . . . . . . . . . . . $105
Stand-alone module.
Two challenges.
530 Urinalysis Module . . . . . . . . . . . . . . . . . . . . . . . $105
Includes modules 531 and 532.
One challenge each unless otherwise noted
in parentheses.
540 Urine hCG (Add-On) . . . . . . . . . . . . . . . . . . . . . . .$27
Same as 541.
Only available with 530, 531.
Bilirubin
pH
Blood/Hemoglobin
Protein
Nitrite
Specific Gravity
Glucose
Microalbumin
Ketones
(dipstick only)
Urobilinogen
Leukocyte Esterase
Urine Sediment Identification (2)
541 Urine hCG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$81
Stand-alone module.
One challenge.
901 Waived and PPM Package . . . . . . . . . . . . . . . . . .$249
531 Urinalysis Dipstick . . . . . . . . . . . . . . . . . . . . . . . .$84
Number of challenges noted in parentheses.
Fecal Occult Blood* (2)
Urine hCG (1)
Hemoglobin (2)
Urine Sediment (2)
Hematocrit (2)
Strep A Antigen
PPM (6)**
Detection (2)
Urinalysis (1)
Whole Blood Glucose (2)
*Fecal occult blood testing is not required by CAP.
**Scabies examination is not required by CAP.
hCG not included.
One challenge each.
Bilirubin
Blood/Hemoglobin
Nitrite
Glucose
Ketones
Urobilinogen
*Fecal occult blood testing is not required by CAP.
pH
Protein
Specific Gravity
Microalbumin
(dipstick only)
Leukocyte Esterase
532 Urine Sediment Identification . . . . . . . . . . . . . . $108
Two challenges consisting of photographs.
533 Urine Sediment Identification (Add-On) . . . . . . . .$27
Same as 532. Only available with 531, 534, 541.
536 Urine Microalbumin/Creatinine (Add-On) . . . . . . .$87
Same as 539. Only available with 530, 531, 541, 868,
872.
902 Basic Waived and PPM Package . . . . . . . . . . . . .$210
Number of challenges noted in parentheses.
Fecal Occult Blood* (2)
Urinalysis (1)
PPM (6)**
Urine hCG (1)
Strep A Antigen
Urine Sediment (2)
Detection (2)
Whole Blood Glucose (2)
*Fecal occult blood testing is not required by CAP.
**Scabies examination is not required by CAP.
539 Urine Microalbumin/Creatinine . . . . . . . . . . . . . .$108
Stand-alone module.
Compatible with quantitative and semi-quantitative
(dipstick) methods.
One challenge each.
537 Fecal Occult Blood (Add-On) . . . . . . . . . . . . . . . . .$81
Same as 542.
Only available with 530, 531, 532, 534, 541.
*Fecal occult blood testing is not required by CAP.
Medical Laboratory Evaluation 2016
CAP accepted analytes
www.acponline.org/mle
7
2016 SHIP DATES M1: Feb. 1 • M2: May 16 • M3: Sept. 12
Microbiology
648 Colony Count* . . . . . . . . . . . . . . . . . . . . . . . . . . .$207
*Colony Count does not contribute to the overall
minimum of five bacteriology challenges!
The specimens included may contain dangerous pathogens
and must be treated with extreme care. These specimens
must be handled and disposed of only by personnel
trained to work with pathogenic microorganisms.
630 Bacteriology 1 . . . . . . . . . . . . . . . . . . . . . . . . . . .$306
No presumptive identification may be submitted for
this module.
For presumptive identification, order module 647.
Two challenges.
649 Urine Presumptive ID/Strep A Antigen
Detection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$315
Consists of each of the following:
Best suited for urine paddle-dipping methods.
Urine Culture (1)
Gram Stain (2)
Antimicrobial
Throat Culture (1)
Genital Culture (1)
Susceptibility Testing (1)
Gram Stain Morphology (2)
Presumptive
Colony Count (2)
Antimicrobial
Identification (2)
Gram Stain (1)
Susceptibility Testing (1)
(directly from
Strep A Antigen
sample provided)
Detection (5)
Gram Stain Morphology (1)
Plus, an additional three challenges from the
following sources: blood, CSF, wound, respiratory,
and/or stool for a total of 6 cultures each shipment.
652 Urine Presumptive ID/Throat Culture . . . . . . . . .$333
Best suited for urine paddle-dipping methods.
640 Bacteriology 2 . . . . . . . . . . . . . . . . . . . . . . . . . . .$294
Urine Culture (2)
Strep A Antigen
Throat Culture (2)
Detection (1)
Gram Stain (2)
Antimicrobial
Genital Culture (1)
Susceptibility Testing (1)
Gram Stain Morphology (2)
643 Urine Culture . . . . . . . . . . . . . . . . . . . . . . . . . . . .$282
Urine Culture (5)
Gram Stain (1)
Antimicrobial
Gram Stain
Susceptibility Testing (1)
Morphology (1)
644 Urine Culture/Strep A Antigen Detection . . . . . .$273
Urine Culture (2)
Strep A Antigen
Gram Stain (1)
Detection (3)
Antimicrobial
Gram Stain
Susceptibility Testing (1)
Morphology (1)
Presumptive
Identification (2)
Gram Stain (1)
(directly from
sample provided)
Colony Count (2)
Antimicrobial
Susceptibility Testing (1)
Throat Culture (3)
Gram Stain
Morphology (1)
650 Gram Stain . . . . . . . . . . . . . . . . . . . . . . . . . . . . $177
Five fixed glass slides.
Five challenges each.
Gram Stain
Gram Stain Morphology
641 Throat Culture . . . . . . . . . . . . . . . . . . . . . . . . . .$282
Not suitable for Strep A kits.
Five challenges.
642 Throat Culture/Strep A Antigen Detection . . . . .$273
645 Urine/Throat Culture . . . . . . . . . . . . . . . . . . . . . .$288
Urine Culture (3)
Throat Culture (2)
Gram Stain (1)
Antimicrobial
Gram Stain Morphology (1) Susceptibility Testing (1)
Throat Culture (2)
Strep A Antigen
Detection (3)
660 Strep A Antigen Detection . . . . . . . . . . . . . . . . $174
Not suitable for culture.
647 Urine Presumptive ID/Colony Count . . . . . . . . . .$333
Five challenges.
Best suited for paddle-dipping methods.
Presumptive
Colony Count (2)
Identification (5)
Antimicrobial
Gram Stain (1)
Susceptibility Testing (1)
Gram Stain Morphology (1)
662 Strep A Antigen Detection—Waived . . . . . . . . . $108
For waived Strep A Antigen Detection kits only.
Two challenges.
646 Genital Culture . . . . . . . . . . . . . . . . . . . . . . . . . .$282
Genital Culture (5)
Gram Stain (1)
Gram Stain Morphology (1)
8
www.acponline.org/mle
CAP accepted analytes
Medical Laboratory Evaluation 2016
2016 SHIP DATES M1: Feb. 1 • M2: May 16 • M3: Sept. 12
654 Genital Culture (Add-On) . . . . . . . . . . . . . . . . . .$123
Same as 646. Only available with 641 through 645,
647, 649, 650, 652, 660, 670.
Genital Culture (2)
Gram Stain (1)
Gram Stain
Morphology (1)
681 Respiratory Antigen Detection . . . . . . . . . . . . . .$285
Five challenges each.
Influenza A
Influenza B
Influenza A/B Combo
RSV
682 C. difficile/Rotavirus Antigen Detection . . . . . . .$249
668 Affirm VP III (DNA) . . . . . . . . . . . . . . . . . . . . . . .$399
Five challenges each.
Candida sp.
Gardnerella vaginalis
Trichomonas vaginalis
670 Chlamydia (EIA, DNA) . . . . . . . . . . . . . . . . . . . . .$327
Five challenges.
Five challenges each.
C. difficile Toxin/
Common Antigen
Rotavirus
683 Giardia lamblia/Cryptosporidium Antigen
Detection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$300
Five challenges each.
Cryptosporidium
Giardia lamblia
675 Chlamydia/GC (EIA, DNA) . . . . . . . . . . . . . . . . . .$354
Five challenges each.
Chlamydia trachomatis
686 Legionella Antigen Detection . . . . . . . . . . . . . . .$225
Neisseria gonorrhoeae
673 Chlamydia (EIA, DNA)—Add-On . . . . . . . . . . . . .$144
Same as 670. Only available with 630 through 647,
649, 650, 652, 660.
Two challenges.
Five challenges.
687 Streptococcus pneumoniae Antigen Detection . .$225
For use with the Binax NOW Streptococcus pneumoniae
Urinary Antigen Detection kit only.
Note
Five challenges.
• Federal law requires a minimum of five CMS
regulated (non-waived methods) bacteriology
challenges per shipment. Individual state laws may
differ. When enrolling, ensure your order meets the
requirement that is the most stringent of the two.
• All urine culture specimens are suitable for
presumptive identification (ie, growth/no growth,
Gram stain interpretation) and/or definitive
identification (ie, genus and/or species).
• The number of challenges is noted in parentheses.
678 Dermatophyte Screen . . . . . . . . . . . . . . . . . . . . .$189
Appropriate for determining the presence or absence
of dermatophytes.
Two challenges.
538 KOH Slides . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$153
Two fixed glass slides for determining the presence or
absence of fungal elements in skin scrapings.
Two challenges.
680 Respiratory Antigen Detection—Waived . . . . . . .$186
690 Parasitology . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$276
Provides five challenges from among the following:
PVA Slide (for permanent stain), Fecal Suspension
(direct wet mount examination for ova and parasites),
Blood Smear for Parasites.
695 MRSA Screening . . . . . . . . . . . . . . . . . . . . . . . . .$267
Screening for the prescence or absence of methicillinresistant Staphylococcus aureus only.
Five challenges.
Immunology
750 Immunology Module . . . . . . . . . . . . . . . . . . . . . .$264
Five challenges each.
Infectious Mononucleosis
Rheumatoid Factor
Anti-Streptolysin O
(ASO)
751 Rheumatology Module . . . . . . . . . . . . . . . . . . . .$186
Includes 763 and 764.
Two challenges each.
Influenza A
Influenza B
For use with the Binax NOW Legionella Urinary
Antigen Detection kits only.
Influenza A/B Combo
RSV
Medical Laboratory Evaluation 2016
C-Reactive Protein (2)
Rheumatoid Factor (5)
Not for high-sensitivity methods
CAP accepted analytes
www.acponline.org/mle
9
2016 SHIP DATES M1: Feb. 1 • M2: May 16 • M3: Sept. 12
755 Infectious Mononucleosis—Waived . . . . . . . . . . .$111
782 ANA Expanded . . . . . . . . . . . . . . . . . . . . . . . . . .$240
For waived Infectious Mononucleosis kits only.
For non-latex methods ONLY.
Two challenges.
Five challenges each.
762 Infectious Mononucleosis . . . . . . . . . . . . . . . . . .$183
Five challenges.
761 Infectious Mononucleosis/Rheumatoid Factor . . .$246
Includes 762 and 763.
ANA
Anti-dsDNA
Anti-RNP
Anti-RNP/Sm
Anti-SSA
Anti-SSB
Anti-SSA/SSB
Anti-Sm
783 ANA Expanded (Add-On) . . . . . . . . . . . . . . . . . .$180
Same as 782. Only available with 750, 751.
Five challenges each.
For non-latex methods ONLY.
763 Rheumatoid Factor . . . . . . . . . . . . . . . . . . . . . . .$180
784 Complement/Immunoglobulins . . . . . . . . . . . . . .$213
Five challenges each.
Five challenges.
764 C-Reactive Protein (CRP) . . . . . . . . . . . . . . . . . . .$108
Not for high-sensitivity methods.
Two challenges.
Complement C3
Complement C4
IgA, Total
IgG, Total
IgM, Total
771 Rubella . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$177
776 C-Reactive Protein (CRP)—Add-On . . . . . . . . . . . .$57
Not for high-sensitivity methods.
Only available with 750.
For lgG methods only.
Five challenges.
772 Syphilis Serology . . . . . . . . . . . . . . . . . . . . . . . . .$198
Five challenges each.
765 High-Sensitivity C-Reactive Protein (HS-CRP) . . .$111
Two challenges.
777 High-Sensitivity C-Reactive Protein
(HS-CRP)—Add-On . . . . . . . . . . . . . . . . . . . . . . . .$60
MHA-TP
RPR
TPA
VDRL
789 diagnostics direct Syphilis Health Check . . . . . . .$210
Five challenges each.
TPA - For the Syphilis Health Check ONLY.
RPR - For use with any RPR methods.
Only available with 750, 751.
Two challenges.
766 Antinuclear Antibody (ANA) . . . . . . . . . . . . . . . .$171
770 Specific Allergen Testing . . . . . . . . . . . . . . . . . . .$336
For Latex methods ONLY.
Number of challenges noted in parentheses.
Five challenges.
Includes 2 sets of samples for large volume requirements.
Does not include Total IgE.
778 Antinuclear Antibody (ANA)—Add-On . . . . . . . .$108
Same as 766.
For Latex methods ONLY. Only available with 751.
767 Antinuclear Antibody (ANA) . . . . . . . . . . . . . . . .$183
For non-latex methods ONLY.
779 Antinuclear Antibody (ANA)-Add-On . . . . . . . . .$120
For non-latex methods ONLY.
Only available with 751.
740 Additional Specific Allergen Material . . . . . . . . . . $78
Includes 1 additional set of samples for large volume
requirements.
Only available with 773.
Allergen Specific IgE (14)
Five challenges.
Same as 767.
Allergen Specific IgE (14)
773 Diagnostic Allergy . . . . . . . . . . . . . . . . . . . . . . . .$336
Number of challenges noted in parentheses.
Allergen Specific IgE (14)
Total IgE (5)
774 Lyme Disease Serology . . . . . . . . . . . . . . . . . . . .$216
Two challenges.
Anti-Borrelia burgdorferi
*Lyme Disease Serology is not required by CAP.
10
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CAP accepted analytes
Medical Laboratory Evaluation 2016
2016 SHIP DATES M1: Feb. 1 • M2: May 16 • M3: Sept. 12
775 Viral Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . .$450
Five challenges each.
Anti-HAV (IgM)
Anti-HAV (Total/IgG)
Anti-HBc (IgM)
Anti-HBc (Total/IgG)
Anti-HBs
812 Piccolo Waived Chemistry . . . . . . . . . . . . . . . . . .$210
For the Abaxis Piccolo Instrument (waived cartridges
ONLY).
Anti-HCV
Anti-HIV
HBeAg
HBsAg
Two challenges each.
780 H. pylori Antibody Detection . . . . . . . . . . . . . . .$153
Two challenges.
781 Mycoplasma . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$135
IgG only.
Albumin
Alkaline Phosphatase
ALT (SGPT)
Amylase
AST (SGOT)
Calcium
Chloride
Cholesterol
CO2
Phosphorus
Creatine Kinase Potassium
(CK)
Sodium
Creatinine
Total Bilirubin
GGT
Total Protein
Glucose
Triglyceride
HDL Cholesterol Urea Nitrogen
LDL Cholesterol Uric Acid
- Calculated*
*LDL Cholesterol - Calculated is not required by CAP.
817 i-STAT Chemistry 1 . . . . . . . . . . . . . . . . . . . . . . . .$336
Two challenges.
Five challenges.
790 Anti-HIV—Waived . . . . . . . . . . . . . . . . . . . . . . . .$159
For i-STAT analyzer only. Includes 818 and 847.
For waived HIV kits only.
818 i-STAT Chemistry 2 . . . . . . . . . . . . . . . . . . . . . . . .$237
Two challenges.
For i-STAT analyzer only.
791 Anti-HIV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$312
Five challenges.
Five challenges each.
Chloride
Ionized Calcium
Creatinine
Potassium
Glucose
Sodium
Hematocrit
tCO2 *
Hemoglobin
Urea Nitrogen
*tCO2 is not required by CAP.
Chemistry
Chemistry Ordering Tips
832 i-STAT Chemistry—Waived . . . . . . . . . . . . . . . . . .$168
• If you perform chemistry panels designed to match
CPT panels, see modules 813 through 816, which are
configured to match CPT profiles.
For i-STAT analyzer (Waived cartridges only).
Two challenges each.
• If you use the i-STAT instrument, select modules 817, 818, or 832
which are specifically for i-STAT instruments.
Please pay close attention to instrument compatibility notes when
selecting any of the chemistry modules.
If you need further assistance, call MLE Customer Service at
1-800-338-2746, option 5, or e-mail us at [email protected].
Chloride
Ionized Calcium
Creatinine
Potassium
Glucose
Sodium
tCO2 *
Hematocrit
Hemoglobin
Urea Nitrogen
*tCO2 is not required by CAP.
810 Chemistry Module . . . . . . . . . . . . . . . . . . . . . . . .$342
811 Lipid Panel/Glucose - Waived . . . . . . . . . . . . . . .$168
Includes CMP, BMP, hepatic, thyroid and lipid profiles.
For Waived testing ONLY.
Includes 821, 822, 823, 825, 827, 842.
Two challenges each.
Five challenges.
Cholesterol, Total
LDL Cholesterol - Calculated*
Glucose
Triglyceride
HDL Cholesterol
*LDL Cholesterol - Calculated is not required by CAP.
833 Piccolo Waived Chemistry (Add-On) . . . . . . . . . . .$75
Same as 812. Only available with 824.
NEW!
813 Comprehensive Metabolic Panel . . . . . . . . . . . . .$276
Includes 814, 816, 822.
Five challenges.
814 Basic Metabolic Panel . . . . . . . . . . . . . . . . . . . . .$216
Five challenges each.
Calcium
Chloride
CO2
Creatinine
Medical Laboratory Evaluation 2016
CAP accepted analytes
Glucose
Potassium
Sodium
Urea Nitrogen
www.acponline.org/mle
11
2016 SHIP DATES M1: Feb. 1 • M2: May 16 • M3: Sept. 12
815 Hepatic Profile . . . . . . . . . . . . . . . . . . . . . . . . . . .$210
Five challenges each.
Albumin
Alkaline Phosphatase
ALT (SGPT)
AST (SGOT)
Five challenges each.
Direct Bilirubin
Total Bilirubin
Total Protein
816 Hepatic Profile (Add-On) . . . . . . . . . . . . . . . . . . . .$45
Same as 815. Only available with 814, 819-821, 824,
826, 828, 830, 834.
819 Chemistry 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$192
Five challenges each.
Cholesterol, Total
Glucose
828 Enzyme Chemistry - Ship Alone . . . . . . . . . . . . .$216
ALT (SGPT)
Alkaline Phosphatase
Amylase
AST (SGOT)
NEW!
Creatine Kinase (CK)
GGT
LDH
Lipase
823 Enzyme Chemistry (Add-On) . . . . . . . . . . . . . . . . .$45
Same as 828. Only available with 813-815, 819–821,
824, 826, 830, 834.
824 Thyroid Profile . . . . . . . . . . . . . . . . . . . . . . . . . . .$237
Five challenges each.
Urea Nitrogen
Potassium
820 Chemistry 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$228
Alpha-fetoprotein (AFP)
Cortisol
Free T3
Free Thyroxine (T4)
T3 Uptake
Thyroxine (T4)
Triiodothyronine (T3)
TSH
Five challenges each.
Total Bilirubin
Chloride
Cholesterol, Total
CO2
Creatinine
Glucose
Potassium
Sodium
Urea Nitrogen
Uric Acid
821 Chemistry 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$258
Five challenges each.
Total Bilirubin
LDL Cholesterol Chloride
Direct
Cholesterol, Total
Potassium
CO2
Sodium
Creatinine
Triglyceride
Glucose
Urea Nitrogen
HDL Cholesterol
Uric Acid
LDL Cholesterol Calculated*
*LDL Cholesterol - Calculated is not required by CAP.
834 Additional Chemistries . . . . . . . . . . . . . . . . . . . .$216
825 Thyroid Profile (Add-On) . . . . . . . . . . . . . . . . . . . .$54
Same as 824. Only available with 813–815, 819–821,
826, 828, 830, 834.
826 Lipid Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$228
Five challenges each.
Cholesterol, Total
LDL Cholesterol HDL Cholesterol
Direct
LDL Cholesterol Triglyceride
Calculated*
*LDL Cholesterol - Calculated is not required by CAP.
827 Lipid Profile (Add-On) . . . . . . . . . . . . . . . . . . . . . .$45
Same as 826. Only available with 813-815, 819, 824, 828,
830, 834.
829 Apolipoproteins . . . . . . . . . . . . . . . . . . . . . . . . . .$129
Two challenges each.
Apolipoprotein A1
Stand alone module.
Five challenges each.
Albumin
Total Protein
Calcium
TIBC - Calculated*
Iron
TIBC - Direct
Lactic Acid
UIBC - Direct
Magnesium
Uric Acid
Phosphorus
*TIBC - Calculated is not required by CAP.
Apolipoprotein B
830 Therapeutic Drug Monitoring . . . . . . . . . . . . . . .$225
Five challenges each.
Acetaminophen
Carbamazepine
Digoxin
Gentamicin
Lithium
Phenobarbital
Phenytoin
Salicylate
Theophylline
Valproic Acid
Vancomycin
831 Therapeutic Drug Monitoring (Add-On) . . . . . . . .$60
822 Additional Chemistries (Add-On) . . . . . . . . . . . . . .$45
Same as 834. Only available with 814, 815, 819-821,
824, 826, 828, 830.
Same as 830. Only available with 810, 813–815,
819–821, 824, 826, 828, 834.
835 Serum Alcohol/Acetone . . . . . . . . . . . . . . . . . . . .$225
Five challenges.
12
www.acponline.org/mle
CAP accepted analytes
Medical Laboratory Evaluation 2016
2016 SHIP DATES M1: Feb. 1 • M2: May 16 • M3: Sept. 12
836 Ammonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$159
Two challenges.
855 Fructosamine . . . . . . . . . . . . . . . . . . . . . . . . . . . .$153
NOT compatible with the LXN Test System.
Two challenges.
837 Blood Lead . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$336
854 SHBG/Testosterone
Five challenges.
. . . . . . . . . . . . . . . . . . . . . .$318
Lyophilized samples.
838 Blood Lead—Waived . . . . . . . . . . . . . . . . . . . . . .$201
Two challenges.
841 Neonatal Bilirubin . . . . . . . . . . . . . . . . . . . . . . . .$219
Five challenges each.
Direct Bilirubin
NEW!
Two challenges each.
Sex Hormone Binding
Globulin
Testosterone, Bioavailable
Testosterone, Free
Testosterone
859 PSA (Add-On) . . . . . . . . . . . . . . . . . . . . . . . . . . . .$57
Total Bilirubin
Same as 861. Only available with 860.
842 Direct Bilirubin (Add-On) . . . . . . . . . . . . . . . . . . . .$39
Same as 843.
Only available with 814, 819–821, 824, 826, 828.
843 Direct Bilirubin . . . . . . . . . . . . . . . . . . . . . . . . . .$141
Five challenges.
845 Cardiac Markers . . . . . . . . . . . . . . . . . . . . . . . . .$297
Five challenges each. Quantitative only.
BNP
CK-MB
D-Dimer
Myoglobin
NT-proBNP
Troponin I
Troponin T
860 Endocrinology/Hematology/Oncology . . . . . . . .$216
Two challenges each.
CEA
DHEA-S
Estradiol
Ferritin
Folate
FSH
Homocysteine
LH
Progesterone
Prolactin
Testosterone
Transferrin
Vitamin B12
861 PSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$129
Two challenges.
846 BNP/D-Dimer . . . . . . . . . . . . . . . . . . . . . . . . . . . .$213
B-type Natriuretic Peptide
862 Tumor Markers . . . . . . . . . . . . . . . . . . . . . . . . . .$381
Two challenges each.
Two challenges.
Beta (b)-2 Microglobulin
CA 125
CA 15-3
CA 19-9
BNP*
NT-proBNP
D-Dimer
*CAP accepted for waived methods only.
CA 27/29
CEA
Free PSA
PSA
Thyroglobulin
847 Blood Gases . . . . . . . . . . . . . . . . . . . . . . . . . . . .$288
Compatible with the i-STAT analyzer as well as other
blood gas instruments.
Five challenges each.
Chloride
Ionized Calcium
Lactic Acid
pCO2
863 Endocrinology 2 . . . . . . . . . . . . . . . . . . . . . . . . .$186
Lyophilized samples.
Two challenges each.
pH
pO2
Potassium
Sodium
C-Peptide
Insulin
864 Thyroid Antibodies . . . . . . . . . . . . . . . . . . . . . . .$228
850 Glycohemoglobin . . . . . . . . . . . . . . . . . . . . . . . .$180
Two challenges each.
Thyroglobulin Antibody
NOT compatible with Afinion analyzer.
CAP accepted for waived methods only.
Two challenges.
Thyroid Microsomal
Antibody (Anti-TPO)
865 Serum hCG . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$171
851 Afinion Glycohemoglobin . . . . . . . . . . . . . . . . . .$192
Two challenges.
Parathyroid hormone
(PTH)
Vitamin D, 25-Hydroxy
Five challenges.
866 Serum hCG (Add-On) . . . . . . . . . . . . . . . . . . . . . . .$87
Same as 865. Only available with 810, 813, 814, 815,
819, 820, 821, 824, 826, 828, 834.
Medical Laboratory Evaluation 2016
CAP accepted analytes
www.acponline.org/mle
13
2016 SHIP DATES M1: Feb. 1 • M2: May 16 • M3: Sept. 12
872 Urine Chemistry . . . . . . . . . . . . . . . . . . . . . . . . . .$219
Two challenges each.
Amylase
Calcium
Chloride
Creatinine
Glucose
Magnesium
Osmolality
Phosphorus
Potassium
Sodium
Total Protein
Urea Nitrogen
Uric Acid
868 Urine Drug Screen . . . . . . . . . . . . . . . . . . . . . . . .$198
Two challenges each.
For the qualitative detection of drugs in urine. 10ml each.
Each challenge will include one or more of the following:
Acetaminophen
Amphetamines
Amphetamines/
Methamphetamines
Barbiturates
Benzodiazepines
Buprenorphine
Cannabinoids (THC)
Cocaine Metabolites
Cotinine
EDDP
Ethanol (Alcohol)
Fentanyl
LSD
MDMA
Methadone
Methamphetamines
Methanol
Methaqualone
6-Monoacetylmorphine
Opiates (Morphine
Trihydrate)
Oxycodone
Phencyclidine
Propoxyphene
Tramadol
Tricyclic Antidepressants
870 Whole Blood Glucose . . . . . . . . . . . . . . . . . . . . .$255
Five challenges.
871 Whole Blood Glucose—Waived . . . . . . . . . . . . . .$153
Two challenges.
880 Additional Chemistry Testing Material . . . . . . . .$108
Includes all analytes in Chemistry Module 810 and
Therapeutic Drug Monitoring Module 830. It is the
same material used in those modules and will be
shipped to your laboratory at the same time as your
regular Chemistry samples. You can use it as:
Waived Testing
Waived Testing—The Importance of
Performing Proficiency Testing
Certificate of Waiver (CW) laboratories must only perform
waived laboratory tests. When the Centers for Medicare
& Medicaid Services (CMS) began random inspections of
some CW laboratories in 2002, many laboratories chose to
participate in proficiency testing as a quality assurance
check. MLE responded by preparing special two-sample
proficiency modules, designed for the needs of the waived
testing laboratory. Our custom selection of waived modules
appears on the following pages.
E-notification Service
A value-added service to enhance the quality and safety of
patient care. The e-mail notification service will provide
Class I and Class II recall information and field corrections
pertaining to waived test devices.
Class I recalls are those that have a “probable risk
of harm or death” to a patient if the items remain
in use. Class II recalls have a “significant risk of
harm” to a patient if they remain in use.
In addition to the recall e-notification service, MLE provides:
• Notification of changes or additions to the CMS list
of waived laboratory tests.
• A wide array of cost-saving Waived Testing Modules
for continued quality assurance at a lower cost.
• A reminder prompt for notifications involving
Microbiology tests, to ensure regulatory compliance
for any remaining non-waived analytes.
To receive “E-Notify on Waived Tests” and the “Recalls and
Field Corrections: Devices—Class I and Class II” report,
send an e-mail to [email protected] and request to be
added to the recipient list. In the e-mail request, be sure to
include your MLE ID number.
• Extra PT material in case you have a problem and
need extra testing material.
• A way to double-check unacceptable PT results after
corrective action.
• An educational tool to train personnel.
• A means to meet the CMS quality assurance
requirements for a second chemistry instrument.
14
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CAP accepted analytes
Medical Laboratory Evaluation 2016
2016 SHIP DATES M1: Feb. 1 • M2: May 16 • M3: Sept. 12
Cost Effective Package for Waived Testing
901 Waived and PPM Package . . . . . . . . . . . . .$249
Number of challenges noted in parentheses.
Fecal Occult Blood* (2)
Urine hCG (1)
Hemoglobin (2)
Urine Sediment (2)
Hematocrit (2)
Strep A Antigen
PPM (6)**
Detection (2)
Urinalysis (1)
Whole Blood Glucose (2)
*Fecal occult blood testing is not required by CAP.
**Scabies examination is not required by CAP.
902 Basic Waived and PPM Package . . . . . . . . . . . . .$210
Number of challenges noted in parentheses.
Fecal Occult Blood* (2)
Urinalysis (1)
PPM (6)**
Urine hCG (1)
Strep A Antigen
Urine Sediment (2)
Detection (2)
Whole Blood Glucose (2)
*Fecal occult blood testing is not required by CAP.
**Scabies examination is not required by CAP.
“E-Notify”
Notification of newly waived tests and FDA Recalls
delivered to your e-mail account . . . . . . . . . . . . . . . .FREE
To sign up for “E-Notify,” send an e-mail to
[email protected].
Continuing Education
MLE CEexpress
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .FREE
MLE offers continuing education through COLA’s
LabUniversity®. MLE CEexpress courses are
provided free of charge to MLE participants.
Discounts available on COLA courses. Call MLE at
1-800-338-2746, option 5 or e-mail us at
[email protected] to learn more.
Discounted
Price
Publication
142 G2’s National Intelligence Report Subscription $176
Bi-weekly newsletter covering government policy for
diagnostic testing and related medical services.
Supplies & Services
Supplies
Off-Schedule Proficiency Testing
121 Pipette—1mL . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$25
For use with 320 and 321. Reusable Class A
volumetric pipette required for reconstitution of
lyophilized proficiency testing specimens.
126 Pipette Pump . . . . . . . . . . . . . . . . . . . . . . . . . . . .$45
For use with product 121 above.
Starts at . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$200
Off-schedule proficiency testing (PT) provides laboratories with immediate, on-demand, customized proficiency testing for reinstatement or remedial purposes;
a complement to the regularly scheduled PT program.
Who Needs Off-Schedule Testing?
107 Hard Copy of Participant Summary for the Year . .$75
108 Additional Program Binder . . . . . . . . . . . . . . . . . .$15
Services
Automatic Program Renewal
• Laboratories with unsuccessful performance (score of
less than 80%) for two out of three regular testing
events may be required to perform off-schedule PT to
lift a “cease-testing” order from their regulatory or
accrediting agency. In these cases, two acceptable proficiency performances (score of 80% or better) may be
required for the lab to resume testing patients.
• Some laboratories use off-schedule PT to verify that
corrective actions were effective.
116 Automatic Program Renewal . . . . . . . . . . . . . . . .FREE
Free yourself from re-enrollment/re-ordering hassles.
We’ll do it for you! To enroll, add module 116 to your
order.
This service is available to every laboratory, regardless of
MLE enrollment status.
For information on cost and availability, contact MLE
Customer Service at 800-338-2746, option 5, or e-mail us at
[email protected].
Online Result Reporting . . . . . . . . . . . . . . . . . . . . . . .FREE
To register or receive more information, send an email to [email protected].
Medical Laboratory Evaluation 2016
CAP accepted analytes
www.acponline.org/mle
15
College of American Pathologists (CAP)
Accepted Analytes for the MLE PT Program—As of JANUARY 1, 2016.
To download, visit: www.acponline.org/running_practice/mle/cap_accepted_analytes.pdf
HEMATOLOGY
Module 210 – Hematology Module
Module 211 – Basic Hematology
Module 212 – Hemoglobin/Hematocrit
Module 213 – Hemoglobin/Hematocrit (waived)
Module 215 – Hemoglobin/Glucose (waived Hemocue only)
Module 223 – Hematology with 5-part Differential (CL samples)
Module 224 – Sysmex with 3-part Differential
Module 225 – Hematology with 3-part Differential
Module 226 – Hematology with 5-part Differential (DIF samples)
Module 228 – Hematology with 5-part Differential (BCX samples)
Module 229 – Hematology with 5-part Differential (MX samples)
Module 230 – Blood Cell Identification (Add-On)
Module 231 – Blood Cell Identification
Module 240 – Reticulocyte Count
Note: Sedimentation rate is not required by CAP
COAGULATION
Module 324 – Roche CoaguChek XS INR
Module 328 – I-STAT Prothrombin Time – PT/INR
Module 330 – CoaguCheck XS Plus – PT/INR
Module 331 – CoaguCheck XS Plus-Waived – PT/INR
BLOOD BANK (IMMUNOHEMATOLOGY)
Module 451 – ABO & Rh Factor (D Type)
Module 452 – Blood Bank 1
Module 453 – Blood Bank 2 – EXCEPT Antibody Identification
URINALYSIS
Module 530 – Urinalysis Module
Module 531 – Urinalysis Dipstick
Module 532 – Urine Sediment Identification
Module 533 – Urine Sediment Identification (Add-On)
Module 536 – Urine Microalbumin/Creatinine (Add-On)
Module 538 – KOH slides (fungal elements)
Module 539 – Urine Microalbumin/Creatinine
Module 540 – Urine hCG (Add-On)
Module 541 – Urine hCG
Module 901 – Waived and PPM Package *
Module 902 – Basic Waived and PPM Package *
* Note: Fecal Occult Blood & Scabies Identification are not required by CAP
PROVIDER-PERFORMED MICROSCOPY (PPM)
Module 534 – Provider-Performed Microscopy (PPM) - Except Scabies Identification
Module 535 – Provider-Performed Microscopy (PPM) (Add-On) - Except Scabies Identification
Note: Scabies Identification is not required by CAP
MICROBIOLOGY
Module 630 – Bacteriology 1
Module 640 – Bacteriology 2
Module 643 – Urine Culture
Module 644 – Urine Culture/Strep A Antigen Detection
Module 645 – Urine/Throat Culture
Module 647 – Urine Presumptive ID/Colony count
Module 648 – Colony Count
Module 649 – Urine Presumptive ID/Strep A Antigen Detection
Module 650 – Gram Stain
Module 652 – Urine Presumptive ID/Throat Culture
Module 641 – Throat Culture
Module 642 – Throat Culture/ Strep A Antigen Detection
Module 660 – Strep A Antigen Detection
Module 662 – Strep A Antigen Detection (waived)
Module 646 – Genital Culture
Module 654 – Genital Culture (Add On)
Module 668 – Affirm VP III (DNA)
Module 670 – Chlamydia (EIA, DNA)
Module 673 – Chlamydia (EIA, DNA) (Add On)
Module 675 – Chlamydia/GC (EIA, DNA)
Module 678 – Dermatophyte Screen
Module 680 – Rapid Antigen Detection 1 (Waived)
Module 681 – Rapid Antigen Detection 1
Module 682 – Rapid Antigen Detection 2
Module 686 – Legionella antigen Detection
Module 687 – Streptococcus pneumonia Antigen detection
Module 695 – MRSA Screening
IMMUNOLOGY
Module 750 – Immunology Module - EXCEPT ASO
Module 751 – Rheumatology Module
Module 755 – Infectious Mononucleosis (waived)
Module 761 – Infectious Mononucleosis/Rheumatoid Factor
Module 762 – Infectious Mononucleosis
Module 763 – Rheumatoid Factor
Module 764 – C-Reactive Protein (CRP)
Module 779 – Antinuclear Antibody (ANA) (Add On) (ELISA)
Module 771 – Rubella
Module 772 – Syphilis Serology – RPR ONLY
Module 780 – H. pylori Antibody Detection
Module 776 – C-Reactive Protein (CRP) (Add On)
Module 765 – High-Sensitivity C-Reactive Protein (HS-CRP)
Module 766 – Antinuclear Antibody (ANA) (Latex method)
Module 767 – Antinuclear Antibody (ANA) (ELISA)
Module 777 – High-Sensitivity C-Reactive Protein (HS-CRP) (Add On)
Module 778 – Antinuclear Antibody (ANA) (Add On) (Latex method)
Module 782 – ANA Expanded - ANA ONLY
Module 783 – ANA Expanded (Add On) - ANA ONLY
Module 775 – Viral Markers: Anti-HBs, Anti-HCV, Anti-HIV & HbsAg ONLY
Module 790 – Anti-HIV-Waived
Module 791 – Anti-HIV
Note: Lyme Disease Serology is not required by CAP
16
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Medical Laboratory Evaluation 2016
College of American Pathologists (CAP)
Accepted Analytes for the MLE PT Program—As of JANUARY 1, 2016.
To download, visit: www.acponline.org/running_practice/mle/cap_accepted_analytes.pdf
CHEMISTRY
Module 810 – Chemistry Module – All analytes EXCEPT AFP & T Uptake *
Module 811 – Lipid Panel/Glucose - Waived *
Module 812 – Piccolo Waived Chemistry *
Module 833 – Piccolo Waived Chemistry (Add-On) *
Module 819 – Chemistry 1
Module 820 – Chemistry 2
Module 821 – Chemistry 3 *
Module 822 – Chemistry (Add On) *
Module 834 – Additional Chemistries *
Module 813 – Comprehensive Metabolic Panel *
Module 814 – Basic Metabolic Panel
Module 815 – Hepatic Profile
Module 816 – Hepatic Profile (Add On)
Module 823 – Enzyme Chemistry (Add On)
Module 828 – Enzyme Chemistry - Ship Alone
Module 824 – Thyroid Profile
Module 826 – Lipid Profile *
Module 825 – Thyroid Profile (Add on)
Module 827 – Lipid Profile (Add on) *
* Note: For TIBC & LDL: CAP does not monitor calculated values; only direct
measurement is accepted.
Module 817 – i-STAT Chemistry 1 **
Chloride
Creatinine
Glucose
Hematocrit
Hemoglobin
Ionized Calcium
Potassium
Sodium
Urea Nitrogen
From blood gas sample:
pH
pO2
pCO2
Module 818 – i-STAT Chemistry 2 **
Module 832 – i-STAT Chemistry-Waived **
** Note: For tCO2: CAP does not monitor calculated values; this analyte is not
required.
Module 830 – Therapeutic Drug Monitoring - Digoxin & Phenytoin ONLY
Module 831 – Therapeutic Drug Monitoring (Add-On) - Digoxin & Phenytoin ONLY
Module 841 – Neonatal Bilirubin
Module 842 – Direct Bilirubin (Add On)
Module 843 – Direct Bilirubin
Module 845 – Cardiac Markers - EXCEPT NT-proBNP & Troponin T
Module 846 – BNP/D-Dimer - EXCEPT NT-proBNP. BNP accepted for
waived methods only
Module 847 – Blood Gases - pH, pO2, pCO2
Module 862 – Tumor Markers
CA 125
CA 15-3
Module 850 – Glycohemoglobin for waived methods only
Module 851 – Afinion Glycohemoglobin
Module 860 – Endocrinology/Hematology/Oncology - EXCEPT Transferrin
Module 861 – PSA
Module 859 – PSA (Add On)
CA 27/29
CEA
Free PSA
PSA
Cocaine Metabolites
Ethanol
MDMA
Methadone
Methamphetamines
Oxycodone
Opiates (Morphine Trihydrate)
Phencyclidine
Propoxyphene
Tricyclic Antidepressants
Module 863 – Endocrinology 2 – Parathyroid hormone (PTH) ONLY
Module 865 – Serum hCG
Module 866 – Serum hCG (Add On)
Module 868 – Urine Drug Screen
Acetaminophen
Amphetamines
Barbiturates
Benzodiazepines
Buprenorphine
Cannabinoids
Module 870 – Whole Blood Glucose
Module 871 – Whole Blood Glucose (waived)
Medical Laboratory Evaluation 2016
www.acponline.org/mle
17
2016 SHIP DATES M1: Feb. 1 • M2: May 16 • M3: Sept. 12
Frequently Asked
Questions
1. Automatic Renewal Option: I do not want to worry about
whether we are enrolled from year to year. Do you have an
automatic renewal option?
We sure do! By checking the Automatic Renewal box on the PT
order form or your renewal form, you will never again have to
worry about proficiency testing enrollment or placing your order
for a new program year. We will automatically re-order the
modules in which you participated the previous year, generate
an order verification for your review, and send an order change
form should you wish to add or delete modules from your
renewed order. Simple. Easy. And best of all, one important
management detail that you never have to worry about again!
See the “Cancelling an Automatic Renewal Order” section for
more information.
2. When to Order: When does my order have to be submitted
to ensure availability of the modules I ordered?
We encourage you to enroll in MLE as soon as you can to guarantee product availability. Enrolling by December 11, 2015, will
ensure that you receive shipments for the entire year. Remember,
payment is not due until 30 days AFTER enrollment.
You may enroll any time during the year at a prorated cost
depending on the availability of specimens. For every missed event
that you are not enrolled, 1/3 of the module price is deducted. The
annual administration fee remains. Note: The online ordering form
automatically displays prorated prices.
3. Order Changes: Can I change my order at any time?
Sure! We make every effort to accommodate new orders or order
changes throughout the year, subject to product availability.
See “New Orders or Additions” and “Cancelling a Module” for
more information.
4. Irregular Order Frequency: Can I order modules outside
my regular order? If so, do I have to be an MLE participant
to order modules from you?
Proficiency Testing is available upon request at any time during
the program year (subject to product availability). Those enrolled
with other PT providers are welcome to call upon MLE for help
with reinstatement and compliance emergencies. See page 15 for
details on off-schedule testing.
5. Individual International Orders: I live outside the United
States and Canada and I am not with a distributor of MLE
in my country. Please tell me about the shipping process.
Individual laboratories outside the U.S. and Canada are subject to
a minimum $50 fee per shipment to cover shipping costs. Some
destinations may be subject to additional S/H. Contact MLE
Customer Service for specific shipping pricing information.
Additionally, MLE cannot replace kits that are delayed or refused
entry into your country. We will not issue credit or refunds on
such shipments.
When enrolling in any of the MLE modules that involve hazardous
material, laboratories outside the U.S., including Canadian laboratories, must send to MLE any copies of the necessary valid permits
for attachment to each shipment. The shipments will not be sent
without required documentation.
Freight charges are not included in the commercial pricing. You
will be invoiced for freight charges AFTER each shipment. These
charges are due BEFORE your evaluation is mailed.
6. Individual Non-Continental U.S. Orders:
Individual Non-Continental U.S. laboratories are subject to a
minimum $15 fee per shipment to cover additional shipping costs
(Alaska and Hawaii excluded).
7. Needing Assistance: What if I need help with my order,
testing, or regulations? Who can I turn to for immediate
service?
18
www.acponline.org/mle
Our friendly and knowledgeable MLE Customer Service
Representatives are available to assist with order selection, billing,
address/name changes, order changes, and regulatory information.
Additionally, experienced laboratory professionals will guide you
through technical issues, interpretation of your results, and steps
necessary for corrective action.
Changes/Cancellations
New Orders or Additions
All new orders must be submitted in writing to MLE. All changes
to an existing order must be submitted in writing to MLE before
they can be entered into the order processing system. You must
send your order changes in writing at least four weeks prior to the
next shipping date to avoid additional shipping fees. MLE ships
three times per year. You may enroll throughout the year.
Note: The MLE catalog lists prices for the full year. After the first
event, module pricing is prorated. If you add a module less than
four weeks prior to the next shipping date, you MAY be subject to
a “rush order” fee. Call MLE Customer Service at 1-800-338-2746,
option 5, for more information.
Cancelling a Module
If we receive your written request for cancellation of a module(s)
at least four weeks prior to the next shipping date, you will not be
held accountable for payment of the module for the remaining
shipments. Unless otherwise requested, we will credit your account
for that amount and the credit will be applied to additions to your
order or toward enrollment for the next year.
If you cancel a module less than four weeks prior to the
next shipping date, you are financially responsible for the
cost of the module for the next shipment. You will NOT be
financially responsible for subsequent shipments. For example, you
cancel (in writing) a module on January 2, 2016. The first shipment (M1) is scheduled to be shipped on February 1, 2016. You are
responsible for the cost of the module for M1 but not for M2 or M3.
Cancelling an Analyte
Please submit a “Test Menu Deletion” form if your laboratory
reported tests during the previous event that have since been
discontinued, but you are not cancelling the module. Download
the form at www.acponline.org/mle/enroll_us.htm, scroll to “Forms
for Current Enrollees,” or copy the form in your MLE Program
Guide, p. 34.
Cancelling the Entire Order
ALL Cancellations must be requested in writing. Failure to return
the Order Verfication Form and/or not paying your invoice are not
indications of cancellation.
We will refund any charges for unshipped specimens if we receive
notification in writing four weeks prior to the next shipping date.
The annual administration fee is non-refundable. Once shipped,
orders for pipettes/pumps are non-refundable and non-returnable.
Cancelling an Automatic Renewal Order
If you are enrolled in Module 116 (automatic renewal) and wish to
cancel your entire order, you are required to contact MLE in writing NO LATER THAN December 11, 2015, to avoid any charges
for the upcoming year. Failure to return the Order Verfication
Form and/or not paying your invoice are not indications of cancellation.
Medical Laboratory Evaluation 2016
Price Matching for
Unmatched Service!
Found a better price? We’ll match it! MLE
protects your need for budgetary constraint
while providing the best possible PT service
in the industry.
Complete the “MLE Price Match Request
Form” (pages 20-21), listing only the tests
you actually perform. This form enables MLE
to match your actual needs to our most
economic offerings and save you the most
money. If our prices aren’t the best, we will
match our competitor’s pricing for the same
test menu coverage. We strive to give you
more of what you need without the excess!
Medical Laboratory Evaluation 2016
www.acponline.org/mle
19
2016 Price Match Request Form:
Fax this form AND your current
PT provider’s quote/order to: 202-835-0440
Medical Laboratory Evaluation
Questions? Contact MLE
800-338-2746, #5 or [email protected]
Contact:__________________________________ Facility:_________________________________________________
Phone:__________________________ Fax:____________________________ Email: ____________________________
Accreditation Service: CAP_________ COLA_________ CMS_________ TJC (JCAHO)________ OTHER:__________
Primary PT Service: AAB_________ AAFP_________ AccuTest_________ CAP Surveys_________CAPExcel_______
API_________ WSLH_________ OTHER:______________________________
Secondary PT Service:_______________________ For which tests?___________________________________________
ABBREVIATION CODE: W = Waived
HEMATOLOGY
__Blood Cell Identification
(manual differential)
__CBC Primary Instrument:
_______________________
__CBC Secondary Instrument:
______________________
__Crystal Screening
__Fluid Cell Count
__Hematocrit __W __NW
__Hemoglobin__W __NW
__Reticulocyte Count
__Sedimentation Rate
Method: ___________________
COAGULATION
__Fibrinogen
__Partial Thromboplastin Time (APTT) or
(PTT)
__Prothrombin Time (PT) I:________
__PT/INR whole blood methods:
__W__NW I:_________________
URINALYSIS
__Creatinine, Urine
__Fecal Occult Blood
__hCG, urine
__Microalbumin, dipstick
__Microalbumin, quantitative
__Urine Chemistry (See next page)
__Urine Dipstick
__Urine Drug Screen
__Urine Sediment Identification
20
NW = Non-Waived
BLOOD BANK
__ABO Group
__Antibody Identification
__Compatibility Testing
__Rh Factor (D Type)
__Unexpected Antibody Detection
PPM
__Fecal Leukocytes
__Fern Testing
__KOH Vaginal Prep
__KOH Skin Prep
__Nasal Eosinophils
__Pinworms
__Scabies
__Sperm
__Wet Mount (Vaginal)
MICROBIOLOGY
__Affirm VPIII (DNA)
__Antimicrobial Susceptibility
Testing
__Chlamydia (EIA/DNA)
__Dermatophyte Screen
__Genital Culture
__GC (EIA/DNA)
__Gram stain
__MRSA Screening
__Stool, Parasitology
__Throat Culture
__Urine Colony Count
__Urine Culture
Method:_____________________
__Culture from other sources:
_______________________________
_______________________________
I = Instrument
ANTIGEN DETECTION
__C difficile
__Cryptosporidium
__Giardia lamblia
__Influenza A/B __W __NW
__Legionella, urine
__Rotavirus
__RSV __W __NW
__Strep A __W __NW
__Strep pneumoniae, urine
IMMUNOLOGY
__Allergen Specific IgE I:_________
__Anti-Streptolysin O (ASO)
__Antinuclear Antibody (ANA)
Method:_______________________
__Anti-dsDNA
__Anti-RNP
__Anti-Sm
__Anti-SSA
__Anti-SSB
__Complement C3/C4
__C-Reactive Protein (CRP)
__C-Reactive Protein, high sensitivity
(HS-CRP)
__H.pylori, Antibody Detection
__IgA, Total
__IgE, Total
__IgG, Total
__IgM, Total
__Infectious Mononucleosis __W __NW
__Lyme Disease Serology
__Mycoplasma (IgG)
__Rheumatoid Factor (RA)
__Rubella
__Syphilis Serology (RPR)
VIRAL MARKERS
__Anti-HAV
__Anti-HBc
__Anti-HBs
__Anti-HCV
__Anti-HIV __W __NW
__HBeAg
__HBsAg
CHEMISTRY
Primary Instrument:
_____________________
Secondary Instrument:
_____________________
LIVER TESTS
__Bilirubin, Total
__Bilirubin, Direct
__Bilirubin, Neonatal
__ALT (SGPT)
__AST (SGOT)
__Alkaline Phosphatase
__Albumin
__GGT
LIPID TESTS
__Cholesterol, Total
__Triglyceride
__HDL Cholesterol
__LDL Cholesterol
THYROID TESTS
__Anti-Thyroglobulin
__Anti-Microsomal (TPO)
__T3, Free
__T3, Total
__T3, Uptake
__T4, Free
__T4, Total
__TSH
ELECTROLYTES
__Sodium
__Potassium
__Chloride
__CO2
OTHER CHEMISTRY
TESTS
__Alcohol, Serum
__Acetone
__AFP
__Ammonia
__Amylase
__Apolipoprotein A1/B
__Calcium
__Cortisol
__Creatine Kinase (CK)
__Creatinine, Serum
__Fructosamine
__Glucose, whole blood
__W__ NW
I:_____________________
__Glucose, serum
__hCG, serum
__Ionized Calcium
__Iron
__Lactic Acid
__Lead __W __NW
__LDH
__Lipase
__Magnesium
__Phosphorus
__Protein, Total
__TIBC/UIBC
__Urea Nitrogen (BUN)
__Uric Acid
URINE CHEMISTRY
__Amylase
__Calcium
__Chloride
__Creatinine
__Glucose
__Magnesium
__Osmolality
__Phosphorus
__Potassium
__Sodium
__Specific Gravity
__Total Protein
__Urea Nitrogen
__Uric Acid
ENDOCRINOLOGY
__C-Peptide
__CEA
__DHEA-S
__Estradiol
__Ferritin
__Folate
__FSH
__Glycohemoglobin
I: __________________
__Homocysteine
__Insulin
__LH
__Parathyroid Hormone (PTH)
__Progesterone
__Prolactin
__PSA, Total
__PSA, Free
__SHBG
__Testosterone, Bioavailable
__Testosterone, Free
__Testosterone
__Transferrin
__Vitamin B12
__Vitamin D, 25-Hydroxy
THERAPEUTIC DRUGS:
__Acetaminophen
__Carbamazepine
__Digoxin
__Gentamicin
__Lithium
__Phenobarbitol
__Phenytoin
__Salicylate
__Theophylline
__Valproic Acid
__Vancomycin
BLOOD GASES
Primary Instrument:
_____________________
Secondary Instrument:
_____________________
__Ionized Calcium
__pCO2
__pH
__pO2
CARDIAC MARKERS
Instrument:
_____________________
__BNP
__CK-MB
__D-Dimer
__Myoglobin
__NT-pro BNP
__Troponin I
__Troponin T
TUMOR MARKERS
__Beta-2 Microglobulin
__CA 125
__CA 15-3
__CA 19-9
__CA 27/29
__Thyroglobulin
OTHER TESTS NOT
LISTED
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
21
2016 SHIP DATES M1: Feb. 1 • M2: May 16 • M3: Sept. 12
How To Order
If you would like assistance with designing the most economical
order or have questions about our service or your order, contact
MLE for assistance at 1-800-338-2746, option 5, or send us an
e-mail at [email protected].
Order Online with Ease!
www.acponline.org/mle
• Click on the “Enrollment Information” link.
• Click on the “2016 MLE PT Online Order Form” link.
• Complete the electronic form. It will calculate pricing for
you. Once you submit the form, it will provide you with a
summary of your order to print for your records. That’s it!
CMS Regional Office.
5. Print the address of the location where the proficiency testing specimens and program paperwork should be shipped (if
different from the “BILL TO” address). We will send the PT
specimens via one-day express delivery to the “SHIP TO”
address. For this reason, we cannot deliver specimens to a
PO Box, so please provide a complete street address.
6. Designate the regulatory agency(ies) or lab consultant(s) to
receive a copy of your PT results by checking the appropriate box. Don’t forget to include the COLA or state agency
number assigned to you, if applicable, and the name,
address, and phone number of any other persons who should
receive a copy of your results.
Indicate “Auto Renewal”
7. Indicate a module number, description and price.
Method of Payment
8. Specify the method of payment by checking the corresponding box.
Order by Fax
Complete the MLE PT order form on page 24. Fax your completed
order form to MLE: 202-835-0440. If using a PO, please fax a copy
of it with the order form.
Order by Mail
Complete the MLE PT order form according to these instructions
and mail it to the address printed on the form.
Note: Purchase Orders (PO) must be accompanied by a renewal
form or order form. POs by themselves will not be accepted.
PT Order Form
Instructions
Enroll in MLE by December 11, 2015, to ensure you receive
shipments for the entire year. You may enroll any time after the
first event at a prorated cost depending on the availability of
specimens.
Using the PT Order Form
Formulate Your Order
Review the catalog to determine the products which best meet your
proficiency testing (PT) needs.
Note any instructions that refer to specific regulatory
requirements or instrument/method compatibility. Choose the
product most appropriate for your testing needs. Please pay
close attention to instrument compatibility notes when
selecting modules.
Top Section
Complete the PT order form (last page of catalog).
1. Indicate whether you are new to the MLE program or
renewing your enrollment.
2. Print the address of the location where the invoice statement should be mailed (“BILL TO”).
Enroll now to ensure the availability of specimens for the
2016 program year. We will not bill you until November.
Subsequent enrollments will be billed within 1 week after
activation and are payable within 30 days.
Invoice Option: FAX (202-835-0440) the order form or
MAIL it to the Washington, DC, address listed on the form.
Billing terms are normally net 30 days from the date of
invoice.
Credit Card Option: FAX (202-835-0440) the order form or
MAIL it to the Washington, DC, address listed on the form.
Check VISA or MasterCard, indicate the card bearer’s name,
card number, CVV2#, and signature and the expiration date.
Check Option: MAIL the order form and check to the
Philadelphia address listed on the form.
Purchase Order (PO) Option: FAX (202-835-0440) the
order form or MAIL the order form and a copy of the PO to
the Washington, DC, address listed on the form.
Billing terms are net 30 days from the date of invoice.
Tax ID: 23-1520302
DUNS NO: 071625974
Amount Due/Discounts
9. Add the cost of all the items you checked to the annual
administration fee of $85.
Enter the total amount in the box. If you qualify for a
discount, please check the appropriate box and provide the
appropriate information.
Next Step
• Photocopy the order form for your records.
• Within two weeks, you should receive an “Order
Verification” confirming receipt of this order. If you do
not receive the order verification within two weeks,
please contact us immediately.
The MLE products you order may contain pathogenic material. By
returning the order form, you assume all risk and responsibility in
connection with the receipt, handling, storage, use, and disposal of
the products.
3. Print the name of the laboratory director.
4. Enter the laboratory’s CLIA identification number. If you do
not know your CLIA identification number, contact your
22
www.acponline.org/mle
Medical Laboratory Evaluation 2016
MLE Proficiency Testing Price List
Code/Description
*Full Year
HEMATOLOGY
210/Hematology . . . . . . . . . . . . . . . . . . . . . . . . .$240
211/Basic Hematology . . . . . . . . . . . . . . . . . . . .$228
212/Hemoglobin/Hematocrit . . . . . . . . . . . . . . .$204
213/Hemoglobin/Hematocrit . . . . . . . . . . . . .$147
215/Hemoglobin/Glucose—HemoCue . . . . . . . .$156
223/Abbott 5-Part Diff . . . . . . . . . . . . . . . . . . . .$330
224/Sysmex 3-Part Diff . . . . . . . . . . . . . . . . . . .$273
225/Hematology 3-Part Diff . . . . . . . . . . . . . . . .$282
226/Hematology 5-Part Diff . . . . . . . . . . . . . . . .$330
228/Hematology 5-Part diffACT 5 & Pentra 60C+ . . . . . . . . . . . . . . . . . . .$330
229/Hematology 5-Part
diff-Sysmex XE/XT . . . . . . . . . . . . . . . . . . . . .$330
230/Blood Cell Id . . . . . . . . . . . . . . . . . . . . . . .$36
231/Blood Cell Id . . . . . . . . . . . . . . . . . . . . . . . .$108
240/Reticulocyte Count . . . . . . . . . . . . . . . . . . .$210
247/Sed Rate . . . . . . . . . . . . . . . . . . . . . . . . . . . .$168
248/Sed Rate-Sedimat15 . . . . . . . . . . . . . . . . . .$168
250/Body Fluid/Cell Ct/Cryst . . . . . . . . . . . . . .$183
Code/Description
*Full Year
648/Colony Count . . . . . . . . . . . . . . . . . . . . . . . .$207
649/Presump.ID/CC/Strep A Antigen . . . . . . . .$315
650/Gram Stain . . . . . . . . . . . . . . . . . . . . . . . . .$177
652/Throat Culture/Urine
Presump ID . . . . . . . . . . . . . . . . . . . . . . . . . . .$333
654/Genital Culture . . . . . . . . . . . . . . . . . . . $123
660/Strep A Antigen Detection . . . . . . . . . . . . .$174
662/Strep A Antigen . . . . . . . . . . . . . . . . . . .$108
668/Affirm VP Antigen Testing . . . . . . . . . . . . .$399
320/Coagulation . . . . . . . . . . . . . . . . . . . . . . . . .$189
321/Prothrombin Time . . . . . . . . . . . . . . . . . . . .$180
324/Roche CoaguChek XS INR . . . . . . . . . .$174
328/i-STAT Pro Time . . . . . . . . . . . . . . . . . . . . .$333
330/CoaguChek XS PLUS Pro Time . . . . . . . . .$285
331/CoaguChek XS PLUS Pro Time . . . . . .$174
BLOOD BANK
450/Rh Factor (D Type) . . . . . . . . . . . . . . . . . . .$237
451/ABO & Rh Factor (D Type) . . . . . . . . . . . . .$276
452/Blood Bank I . . . . . . . . . . . . . . . . . . . . . . . .$378
453/Blood Bank II . . . . . . . . . . . . . . . . . . . . . . .$396
*Full Year
CHEMISTRY
810/Chemistry . . . . . . . . . . . . . . . . . . . . . . . . . .$342
811/Lipid Panel/Glucose . . . . . . . . . . . . . . .$168
812/Piccolo Waived Chemistry . . . . . . . . . . . . . .$210
813/Comp. Metabolic Panel . . . . . . . . . . . . . . . .$276
814/Basic Metabolic Panel . . . . . . . . . . . . . . . . .$216
815/Hepatic Profile . . . . . . . . . . . . . . . . . . . . . . .$210
816/Hepatic Profile . . . . . . . . . . . . . . . . . . . . .$45
817/i-STAT Chemistry 1 . . . . . . . . . . . . . . . . . .$336
670/Chlamydia (EIA, DNA) . . . . . . . . . . . . . . . .$327
818/i-STAT Chemistry 2 . . . . . . . . . . . . . . . . . .$237
819/Chemistry 1 . . . . . . . . . . . . . . . . . . . . . . . . .$192
673/Chlamydia . . . . . . . . . . . . . . . . . . . . . . . .$144
820/Chemistry 2 . . . . . . . . . . . . . . . . . . . . . . . . .$228
675/Chlamydia/GC (EIA, DNA ) . . . . . . . . . . . .$354
821/Chemistry 3 . . . . . . . . . . . . . . . . . . . . . . . . .$258
678/Dermatophyte Screen . . . . . . . . . . . . . . . . .$189
822/Add’l Chemistry . . . . . . . . . . . . . . . . . . . .$45
680/Resp. Antigen Det. . . . . . . . . . . . . . . . . .$186
823/Enzyme Chemistry . . . . . . . . . . . . . . . . . .$45
681/Resp. Antigen Detection . . . . . . . . . . . . . . .$285
682/C. diff/Rotavirus Ag Det. . . . . . . . . . . . . . . .$249
683/Giardia lamblia/
Cryptosporidium Ag Det . . . . . . . . . . . . . . . .$300
COAGULATION
Code/Description
686/Legionella Antigen Detection . . . . . . . . . . .$225
687/Strep Pneumoniae Antigen Det. . . . . . . . . .$225
690/Parasitology . . . . . . . . . . . . . . . . . . . . . . . . .$276
695/MRSA Screen (5 challenges) . . . . . . . . . . . .$267
IMMUNOLOGY
740/Additional Specific Allergen Material . . . . .$78
750/Immunology Module
. . . . . . . . . . . . . . . . .$264
751/Rheumatology Module . . . . . . . . . . . . . . . .$186
755/Infectious Mono . . . . . . . . . . . . . . . . . . .$111
824/Thyroid Profile . . . . . . . . . . . . . . . . . . . . . . .$237
825/Thyroid Profile . . . . . . . . . . . . . . . . . . . . .$54
826/Lipid Profile . . . . . . . . . . . . . . . . . . . . . . . . .$228
827/Lipid Profile . . . . . . . . . . . . . . . . . . . . . . .$45
828/Enzyme Chemistry . . . . . . . . . . . . . . . . . . .$216
829/Apolipoproteins . . . . . . . . . . . . . . . . . . . . . .$129
830/TDM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$225
831/TDM . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$60
832/i-STAT Chemistry . . . . . . . . . . . . . . . . .$168
833/Piccolo Waived Chemistry . . . . . . . . .$75
834/Additional Chemistries . . . . . . . . . . . . . . .$216
835/Serum Alcohol/Acetone . . . . . . . . . . . . . . . .$225
836/Ammonia . . . . . . . . . . . . . . . . . . . . . . . . . . .$159
837/Blood Lead . . . . . . . . . . . . . . . . . . . . . . . . . .$336
838/Blood Lead . . . . . . . . . . . . . . . . . . . . . . .$201
763/Rheumatoid Factor . . . . . . . . . . . . . . . . . . .$180
URINALYSIS
841/Neonatal Bilirubin . . . . . . . . . . . . . . . . . . .$219
842/Direct Bilirubin . . . . . . . . . . . . . . . . . . . .$39
843/Direct Bilirubin . . . . . . . . . . . . . . . . . . . . . .$141
845/Cardiac Markers . . . . . . . . . . . . . . . . . . . . .$297
764/CRP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$108
846/BNP/D-Dimer . . . . . . . . . . . . . . . . . . . . . . . $213
530/Urinalysis . . . . . . . . . . . . . . . . . . . . . . . . . .$105
531/Urinalysis Dipstick . . . . . . . . . . . . . . . . . . . .$84
532/Urine Sed Id . . . . . . . . . . . . . . . . . . . . . . . .$108
533/Urine Sed Id . . . . . . . . . . . . . . . . . . . . . . .$27
534/PPM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$114
535/PPM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$33
536/Microalbumin/Creatinine—Quant . . . . .$87
537/Fecal Occult Blood . . . . . . . . . . . . . . . . . .$81
538/KOH Slides . . . . . . . . . . . . . . . . . . . . . . . . .$153
539/Microalbumin/Creatinine—Quant . . . . . . .$108
540/Urine hCG . . . . . . . . . . . . . . . . . . . . . . . .$27
541/Urine hCG . . . . . . . . . . . . . . . . . . . . . . . . . . .$81
542/Fecal Occult Blood . . . . . . . . . . . . . . . . . . . .$105
765/HS-CRP . . . . . . . . . . . . . . . . . . . . . . . . . . . .$111
847/Blood Gases
766/ANA LATEX . . . . . . . . . . . . . . . . . . . . . . . .$171
850/Glycohemoglobin . . . . . . . . . . . . . . . . . . . . .$180
MICROBIOLOGY
630/Bacteriology 1 . . . . . . . . . . . . . . . . . . . . . . .$306
640/Bacteriology 2 . . . . . . . . . . . . . . . . . . . . . . .$294
641/Throat Culture . . . . . . . . . . . . . . . . . . . . . .$282
642/Throat Culture/Strep A Antigen . . . . . . . . .$273
643/Urine Culture . . . . . . . . . . . . . . . . . . . . . . .$282
644/Urine Culture/Strep Antigen . . . . . . . . . . .$273
645/Urine/Throat Culture . . . . . . . . . . . . . . . . .$288
646/Genital Culture . . . . . . . . . . . . . . . . . . . . . .$282
647/Urine Culture/Presump.ID/CC . . . . . . . . . .$333
761/Infect Mono/Rheumatoid Factor . . . . . . . . .$246
762/Infectious Mono . . . . . . . . . . . . . . . . . . . . . .$183
. . . . . . . . . . . . . . . . . . . . . . . .$288
767/ANA (ELISA/IMMUNO ONLY) . . . . . . . . .$183
851/Afinion Glycohemoglobin . . . . . . . . . . . . . .$192
770/Specific Allergen Testing . . . . . . . . . . . . . . .$336
854/SHBG/Testosterone . . . . . . . . . . . . . . . . . . .$318
771/Rubella . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$177
855/Fructosamine . . . . . . . . . . . . . . . . . . . . . . . .$153
772/Syphilis Serology . . . . . . . . . . . . . . . . . . . . .$198
773/Diagnostic Allergy . . . . . . . . . . . . . . . . . . . .$336
774/Lyme Disease Serology . . . . . . . . . . . . . . . $216
775/Viral Markers . . . . . . . . . . . . . . . . . . . . . . .$450
776/CRP NOT HIGH-SENSITIVITY . . . . . . . . . . . . . . .$57
777/HS-CRP . . . . . . . . . . . . . . . . . . . . . . . . . . .$60
778/ANA (LATEX ONLY) . . . . . . . . . . . . . . .$108
779/ANA (ELISA/IMMUNO ONLY) . . . . . .$120
780/H. pylori Antibody Det . . . . . . . . . . . . . . . .$153
781/Mycoplasma Antibody . . . . . . . . . . . . . . . . .$135
782/ANA Expanded . . . . . . . . . . . . . . . . . . . . . .$240
783/ANA Expanded . . . . . . . . . . . . . . . . . . . .$180
784/Complement/Immunoglobulins . . . . . . . . .$213
859/PSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$57
860/Endocrinology/Hematology/Oncol . . . . . . . .$216
861/PSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$129
862/Tumor Markers . . . . . . . . . . . . . . . . . . . . . .$381
863/Endocrinology 2 . . . . . . . . . . . . . . . . . . . . . .$186
864/Thyroid Antibodies . . . . . . . . . . . . . . . . . . .$228
865/Serum hCG . . . . . . . . . . . . . . . . . . . . . . . . .$171
866/Serum hCG . . . . . . . . . . . . . . . . . . . . . . . .$87
868/Urine Drug Screening—Qual . . . . . . . . . . .$198
870/Whole Blood Glucose . . . . . . . . . . . . . . . . . .$255
871/Whole Blood Glucose . . . . . . . . . . . . . . .$153
872/Urine Chemistry . . . . . . . . . . . . . . . . . . . . .$219
880/Add’l Chem Testing Material . . . . . . . . . . .$108
901/Waived and PPM Package . . . . . . . . . . . . .$249
902/Basic Waived and PPM Package . . . . . . . .$210
789/diagnostics direct Syphilis Health Check .$210
SUPPLIES & SERVICES
790/Anti-HIV . . . . . . . . . . . . . . . . . . . . . . . . .$159
791/Anti-HIV . . . . . . . . . . . . . . . . . . . . . . . . . . .$312
100/Annual Fee (Includes Binder) . . . . . . . . . . . .$85
107/Hard copy of Participant Summary . . . . . . .$75
121/1mL Pipette . . . . . . . . . . . . . . . . . . . . . . . . . .$25
126/Pipette Pump . . . . . . . . . . . . . . . . . . . . . . . . .$45
142/G2 NIR Subscription . . . . . . . . . . . . . . . . . .$176
=Waived • =Add-On • *Enroll after the 1st event and prices are prorated by 1/3 per event.
Medical Laboratory Evaluation 2016
www.acponline.org/mle
23
2016 MLE Proficiency Testing Order Form
1
New Enrollee
Renewing Participant: MLE ID # _________________________
CTLG
5 Ship To: (no PO boxes for kit delivery)
Same as “bill to” address.
2 Bill To: (please clearly print or type)
Contact ________________________________________________
Contact ________________________________________________
Facility Name __________________________________________
Facility Name __________________________________________
Address ________________________________________________
_______________________________________________________
Address ________________________________________________
_______________________________________________________
City _____________________________State ____ZIP _________
City _________________________State________ZIP _________
Country (other than U.S.): _______________________________
Phone ______________________Fax _______________________
Country (other than U.S.) _______________________________
E-mail: ________________________________________________
Phone ______________________Fax _______________________
Ship kit to different address (attach information)
E-mail _________________________________________________
6 Send a copy of my PT results to:
3 Lab Director ____________________________________
CMS State Agency ID #__________________________
CAP/LAP # _________________________________________
COLA ID #__________________________________________
TJC ID # ___________________________________________
Other (attach name, address and phone number)
4 CLIA ID # _______________________________________
Activate Auto Renewal at no charge.
(see page 16 for details)
7
Module #
Description
Price
Ext.
Module #
Description
Price
Ext.
Please note: Cancel a module IN WRITING up to 4 weeks prior to the upcoming shipment to avoid being charged.
The MLE products you have ordered may contain pathogenic material. By returning this order form, you assume all risk and responsibility in connection with the receipt, handling, storage, use,
and disposal of the material.
8 Method of Payment
(Tax ID # 23-1520302) (DUNS #: 071625974)
Send Invoice
Check (payable to ACP/MLE)
U.S. funds drawn on U.S. bank disclosure
Purchase Order # ______________________
Charge to: VISA MasterCard
Card # ___________________________________
Exp. ____________CVV2 (# on back)_________
Name on Card ____________________________
Signature ________________________________
Billing Street Number ____________________
Billing Zip _______________________________
Mailing the Order Form/Renewal Form
WITH check:
AC003
American College of Physicians
190 N. Independence Mall West
Philadelphia, PA 19106-1572
24
www.acponline.org/mle
DISCOUNT OFFERS
WITHOUT check:
Medical Laboratory Evaluation
Suite 700
25 Massachusetts Avenue, NW
Washington, DC 20001-7401
(Offers cannot be combined--see full description on
the following page)
Ongoing Discounts
ACP - SAVE $85
9 Amount Due
Total Cost of Items Above =
$ _______
– Applied Discount Amount
Subtotal =
$ _______
$ _______
+ Annual Administration Fee
85
$ _______
+ Non-Continental Shipping Fee $ _______
(if applicable)
Total Amount Due =
$ _______
FAX this form to: 202-835-0440
(call 1-800-338-2746, option 5,
to confirm receipt of fax)
ACP Member No. ______________________
Multisite - SAVE 10% on 5 or more labs
Management Group Code ____________
Consultant - SAVE 10% on 5 or more labs
Consultant Code_____________________
Government - SAVE 15% (U.S.)
One-Time Discounts
COLA (New to MLE’s COLA) - SAVE $85
CAP - SAVE $85
NEW (New to MLE) - SAVE $85
Medical Laboratory Evaluation 2016
MLE DISCOUNT OFFERS
Your Solution to Savings Starts Here!
Review the table below to see if you qualify for any of the DISCOUNT offers. Then, simply check the appropriate DISCOUNT OFFER
box and complete any other required information on the online or hard copy PT Order Form.
Discount
Savings
Description
Eligibility
Requirements
Ongoing Discounts (applied each year enrolled in MLE)
ACP
Save $85
ACP Members
• Current in or new to MLE and ACP
Multisite
*Save 10%
Multisite
• Current in or new to MLE
• Must have 5 or more enrolled labs
Consultant
*Save 10%
Consultant affiliation
• Current in or new to MLE
• Order must indicate independent consultant
• Consultant must have 5 or more enrolled labs
Government
*Save 15%
State and Federal
agencies(including
FQHC and IHS)
• Current in or new to MLE
One-Time Discounts (applied for 2016 program only)
COLA
Save $85
COLA Members
For add'l benefits, visit:
www.acponline.org/
mle/acp-cola
• New to MLE and current in or new to COLA
CAP
Save $85
CAP accredited
• CAP accredited and new to MLE
NEW
Save $85
New to MLE
• Never enrolled in MLE
• Minimum order of $500
*Percentage discounts are applied to module pricing only.
Note: Select the eligible offer that provides the greatest discount. We are unable to apply more than one DISCOUNT offer.
Price matching also available. See pages 19 to 21.
Proficiency Testing at its Best.
What’s New for 2016
NEW MODULES
Module No.
Description
Catalog Page No.
828
Enzyme Chemistry—Ship Alone
12
833
Piccolo Waived Chemistry (Add-On)
(can be added on to 824, Thyroid Profile)
11
854
SHBG/Testosterone
13
MODULE RECONFIGURATIONS
Module No.
Description
536
Urine Microalbumin/Creatinine
(Add-On) (can now be added on to
868, Urine Drug Screen)
7
868
Urine Drug Screen—Now contains
Fentanyl and Tramadol
14
25 Massachusetts Avenue NW, Suite 700
Washington, DC 20001-7401
Catalog Page No.