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Recurrent Miscarriage/Coagulation Panel with Reflex (without Consultation)
Test Code11469
CPT Codes
81240, 81241, 85300, 85303, 85306, 85613, 85730, 86146 (x3), 86147 (x3), 83516 (x2)
Includes
Lupus Anticoagulant Evaluation with Reflex (PTT-LA and dRVVT with Reflex Confirmations)
Cardiolipin Antibodies (IgA, IgG, IgM)
Beta-2-Glycoprotein I Antibodies (IgG, IgA, IgM)
Protein C Activity
Protein S Antigen, Free
Antithrombin III Activity
Phosphatidylserine/Prothrombin (PS/PT) Antibodies (IgG, IgM)
Prothrombin (Factor II) 20210G→A Mutation Analysis
Factor V (Leiden) Mutation Analysis
If PTT-LA Screen is prolonged (>40 seconds), then Hexagonal Phase Confirmation will be performed at an additional charge (CPT code(s): 85598).
If Hexagonal Phase Confirmation is positive or weakly positive, then Thrombin Clotting Time will be performed at an additional charge (CPT code(s): 85670.
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).
Cardiolipin Antibodies (IgA, IgG, IgM)
Beta-2-Glycoprotein I Antibodies (IgG, IgA, IgM)
Protein C Activity
Protein S Antigen, Free
Antithrombin III Activity
Phosphatidylserine/Prothrombin (PS/PT) Antibodies (IgG, IgM)
Prothrombin (Factor II) 20210G→A Mutation Analysis
Factor V (Leiden) Mutation Analysis
If PTT-LA Screen is prolonged (>40 seconds), then Hexagonal Phase Confirmation will be performed at an additional charge (CPT code(s): 85598).
If Hexagonal Phase Confirmation is positive or weakly positive, then Thrombin Clotting Time will be performed at an additional charge (CPT code(s): 85670.
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
5 mL whole blood collected in an EDTA (lavender-top) tube, and
1 mL frozen platelet-poor plasma (x4) collected in 3.2% sodium citrate (light blue-top) tubes
1 mL frozen platelet-poor plasma (x4) collected in 3.2% sodium citrate (light blue-top) tubes
Minimum Volume
3 mL whole blood • 0.5 mL (x4) plasma
Instructions
•Whole blood sample is for the Factor V Mutation Analysis and Prothrombin (Factor II) Mutation Analysis.
•Platelet-poor plasma is for the remaining tests.
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 four plastic vials. Plasma must be free of platelets (<10,000/mcL). Freeze immediately and ship on dry ice.
Transport Temperature
Whole blood: Room temperature
Plasma: Frozen
Plasma: Frozen
Specimen Stability
Whole blood
Room temperature: 8 days
Refrigerated: 8 days
Frozen: 30 days
Plasma
Room temperature: Unacceptable
Refrigerated: Unacceptable
Frozen: 14 days
Room temperature: 8 days
Refrigerated: 8 days
Frozen: 30 days
Plasma
Room temperature: Unacceptable
Refrigerated: Unacceptable
Frozen: 14 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Hemolysis
Methodology
Chromogenic Clotting Assay • Enzyme Immunoassay (EIA) • Immunoturbidimetric Immunoassay • Polymerase Chain Reaction and Detection
Setup Schedule
Set up and Report available: See individual assays
Reference Range
See Laboratory Report
Clinical Significance
This profile examines the most common hereditary and acquired thrombophilia risk factors associated with recurrent miscarriage or stillbirth.