Dabigatran with Reflex to Thrombin Time

Test Code

91115

CPT Codes
80299<br><strong>This test is not available for New York patient testing.</strong>

Includes

If the Dabigatran result is <45 ng/mL, then Thrombin Clotting Time will be performed at an additional charge (CPT code(s): 85670).

Preferred Specimen

1 mL frozen plasma collected in a 3.2% sodium citrate (light blue-top) tube

Minimum Volume

0.5 mL

Instructions

Whole blood collected in 3.2% citrate (light blue-top tube). Collect 90-120 minutes after the last dose (preferably after at least 3 doses). Centrifuge (light blue-top) tube 15 minutes at approximately 1500 G within 60 minutes of collection. Using a plastic pipette, remove plasma, taking care to avoid the WBC/platelet buffy layer and place into a plastic vial. Centrifuge a second time and transfer platelet-poor plasma into a new plastic vial. Plasma must be free of platelets (<10,000/mcL). Freeze immediately and ship on dry ice.

Transport Container

Transport tube

Transport Temperature

Frozen

Specimen Stability

Room temperature: Unacceptable
Refrigerated: Unacceptable
Frozen: 30 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Gross hemolysis • Visible fibrin clot • Received room temperature • Received refrigerated

Methodology
Clotting Assay

FDA Status
This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Setup Schedule

Set up: Tues, Thurs, Sat; Report available: Next day

Reference Range

64-443 ng/mL

Clinical Significance

Thrombin Clotting Time - This test, also known as thrombin time, is useful for evaluating the presence of heparin and other direct thrombin inhibitor anticoagulants in specimens with prolonged coagulation studies. It is also used to aid in the diagnosis of congenital and acquired disorders of fibrinogen.

Anticoagulant interference: Expected impact by therapeutic levels (potential interference depends upon drug concentration): Vitamin K antagonists (eg. warfarin): no effect; Heparin (UFH or LMWH): prolonged; Dabigatran or Argatroban (Direct Thrombin Inhibitors): prolonged; Rivaroxaban, Apixaban, Edoxaban (Factor Xa Inhibitors): no effect.

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.