Lupus Anticoagulant and Antiphospholipid Confirmation (non-Coumadin) with Consultation

Test Code

19654

CPT Codes
85613, 85730, 86147 (x2), 86146 (x2), Dependent on the complexity of the consultation, 81503 or 81504 or 81505 may be assigned. 81506 may also be billed if high complexity with more than 60 minutes of time spent for the consultation.

Includes

Prolonged aPTT Thrombotic Evaluation
PTT-LA with Reflex to Hexagonal Phase Confirmation
dRVVT Screen with Reflex to dRVVT Confirm and dRVVT 1:1 Mix
Cardiolipin Antibodies (IgG, IgM)
Beta-2-Glycoprotein I Antibodies (IgG, IgM)
Coagulation Consultation

If Staclot-LA from PTT-LA w/Reflex to Hexagonal Phase Confirmation and dRVVT from dRVVT Screen are confirmed negative, then Prothrombin Time (PT), Thrombin Clotting Time (TCT), and Fibrinogen Profile, will be performed
at an additional charge (CPT code(s): 85384, 85610, 85670).

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).

Preferred Specimen

1 mL frozen platelet-poor plasma (x6) collected in 3.2% sodium citrate (light blue-top) tubes

Minimum Volume

0.5 mL (x6)

Instructions

Please see the individual tests for specific specimen requirements, and stabilities.

Transport Temperature

Frozen

Specimen Stability

Room temperature: Unacceptable
Refrigerated: Unacceptable
Frozen: 14 days

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

Gross hemolysis • Grossly lipemic • Received room temperature • Received refrigerated

Methodology
Immunoassay (IA)

Setup Schedule

Set up and Report available: See individual tests

Reference Range

See Laboratory Report

Clinical Significance

This panel is useful for the investigation of a prolonged aPTT in a patient with a thrombotic history, and for providing laboratory evidence for antiphospholipid syndrome. The panel includes testing for cardiolipin and beta-2-glycoprotein I criteria antibodies and clotting based assays for lupus anticoagulant.

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.