Lupus Anticoagulant and Antiphospholipid Confirmation (on Coumadin) with Consultation

Test Code

19674

CPT Codes
85598, 85610, 85613, 85670, 86146 (x2), 86147 (x2), Dependent on the complexity of the consultation, 80503 or 80504 or 80505 may be assigned. 80506 may also be billed if high complexity with more than 60 minutes of time spent for the consultation.

Includes

Prothrombin Time with INR
Thrombin Clotting Time
Cardiolipin Antibodies (IgG, IgM)
Beta-2-Glycoprotein I Antibodies (IgG, IgM)
Hexagonal Phase Confirmation
dRVVT Screen with Reflex to dRVVT Confirm and dRVVT 1:1 Mix
Coagulation Consultation

If dRVVT Screen is prolonged (>45 seconds), then dRVVT Confirm will be performed at an additional charge (CPT code(s): 85597).
If dRVVT Confirm is positive, then dRVVT 1:1 Mixing Study will be performed at an additional charge (CPT code(s): 85613).

Preferred Specimen

1 mL platelet-poor plasma collected in each of six separate 3.2% sodium citrate (light blue-top) tubes

Minimum Volume

0.6 mL (x6)

Instructions

Platelet-poor plasma: Centrifuge light blue-top tube 15 minutes at approximately 1500 x 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

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

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

Methodology
Clot Detection • Clotting Assay • Immunoassay (IA) • Photo/Optical

Setup Schedule

Set up and Report available: See individual tests

Reference Range

See Laboratory Report

Clinical Significance

The Panel is used in confirming the presence of lupus anticoagulant and specific factor inhibitors, providing further evidence of antiphospholipid syndrome, and developing treatment strategies.

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.