TITLE 42 - PUBLIC HEALTH

CHAPTER IV - CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES

SUBCHAPTER G - STANDARDS AND CERTIFICATION

PART 493 - LABORATORY REQUIREMENTS

subpart k - QUALITY SYSTEM FOR NONWAIVED TESTING

493.1253 - Standard: Establishment and verification of performance specifications.

  (a) Applicability. Laboratories are not required to verify or establish performance specifications for any test system used by the laboratory before April 24, 2003.

  (b)(1) Verification of performance specifications. Each laboratory that introduces an unmodified, FDA-cleared or approved test system must do the following before reporting patient test results: (i) Demonstrate that it can obtain performance specifications comparable to those established by the manufacturer for the following performance characteristics: (A) Accuracy.

  (B) Precision.

  (C) Reportable range of test results for the test system.

  (ii) Verify that the manufacturer's reference intervals (normal values) are appropriate for the laboratory's patient population.

  (2) Establishment of performance specifications. Each laboratory that modifies an FDA-cleared or approved test system, or introduces a test system not subject to FDA clearance or approval (including methods developed in-house and standardized methods such as text book procedures), or uses a test system in which performance specifications are not provided by the manufacturer must, before reporting patient test results, establish for each test system the performance specifications for the following performance characteristics, as applicable: (i) Accuracy.

  (ii) Precision.

  (iii) Analytical sensitivity.

  (iv) Analytical specificity to include interfering substances.

  (v) Reportable range of test results for the test system.

  (vi) Reference intervals (normal values).

  (vii) Any other performance characteristic required for test performance.

  (3) Determination of calibration and control procedures. The laboratory must determine the test system's calibration procedures and control procedures based upon the performance specifications verified or established under paragraph (b)(1) or (b)(2) of this section.

  (c) Documentation. The laboratory must document all activities specified in this section.

[68 FR 3703, Jan. 24, 2003; 68 FR 50724, Aug. 22, 2003]