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Prolonged aPTT Thrombotic Evaluation
Test Code19648
CPT Codes
85613, 85730
Includes
PTT-LA w/Reflex to Hexagonal Phase Confirmation
dRVVT Screen with Reflex to dRVVT Confirm and dRVVT 1:1 Mix
Reflex Criteria:
If PTT-LA Screen is prolonged (> 40 seconds), then Hexagonal Phase Confirmation will be performed at an additional charge (CPT code(s): 85598).
If the dRVVT Screen is prolonged (> 45 seconds), the dRVVT Confirmation will be performed at an additional charge (CPT code(s): 85597).
If the dRVVT Confirm is positive, a dRVVT 1:1 mix will be performed at an additional charge (CPT code(s): 85613).
If the Hexagonal Phase Confirm and DRVVT Confirm is negative, then the Prothrombin Time (PT), Thrombin Clotting Time (TCT), and Fibrinogen, will be performed at an additional charge.
Preferred Specimen
1 mL frozen platelet-poor plasma (x4) collected in 3.2% sodium citrate (light blue-top) tubes
Minimum Volume
0.5 mL (x4)
Instructions
Platelet Poor Plasma: 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 Temperature
Frozen
Specimen Stability
Room temperature: Unacceptable
Refrigerated: Unacceptable
Frozen: 14 days
Refrigerated: Unacceptable
Frozen: 14 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Specimens received room temperature • Received refrigerated • Hemolysis
Methodology
Clot Detection
Setup Schedule
Set up: Mon-Fri; Report available: 3-5 days
Reference Range
See Laboratory Report
Clinical Significance
This evaluation is for the patient with a prolonged Activated Partial Thromboplastin Time and a history of thrombosis. The investigation follows a testing algorithm with an endpoint of arriving at a final diagnosis, most commonly a Lupus Anticoagulant.