Ordering Recommendation

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation

Serum separator tube or plain red.

Specimen Preparation

Keep in warm water (37°C) until processed for transport by laboratory; refrigeration of specimen before separation of serum from cells will adversely affect test results. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.25 mL)

Storage/Transport Temperature


Unacceptable Conditions

Plasma or CSF. Refrigerated whole blood. Contaminated, severely hemolyzed, or lipemic, specimens.


After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)


Semi-Quantitative Hemagglutination


Tue, Thu, Sat


2-7 days

Reference Interval

< 1:32 Negative

Interpretive Data

Titers of 1:32 or higher are considered elevated by this technique. Elevated titers are rarely seen except in primary atypical pneumonia and in certain hemolytic anemias. If the agglutination is not reversible after incubation at 37°C, then the reaction is not due to cold agglutinins.

Primary atypical pneumonia can be caused by Mycoplasma pneumoniae, influenza A, influenza B, parainfluenza, and adenoviruses. However, a fourfold rise in the cold agglutinins usually begins to appear late in the first week or during the second week of the disease and begins to decrease between the fourth and sixth weeks.  Low titers of cold agglutinins have been demonstrated in malaria, peripheral vascular disease, and common respiratory disease.

Compliance Category



Hotline History


CPT Codes



Component Test Code* Component Chart Name LOINC
0050175 Cold Agglutinins 5098-9
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.


  • Cold Agglutinin Titer
  • Febrile Agglutinins
Cold Agglutinins