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Venous Thrombosis Hypercoagulability Panel with Reflex (Warfarin Patient)
Test Code11472
CPT Codes
85307, 81240, 85300, 86147 (x2), 85240, 86146 (x2), 85598, 85613
Includes
Activated Protein C Resistance with Reflex to Factor V (Leiden) Mutation
Prothrombin (Factor II) 20210G→A Mutation Analysis
Antithrombin III Activity
Factor VIII Activity, Clotting
Hexagonal Phase Confirm
dRVVT Screen with Reflex to dRVVT Confirm and dRVVT 1:1 Mix
Cardiolipin Antibodies (IgG, IgM)
Beta-2-Glycoprotein I Antibodies (IgG, IgM)
If Activated Protein C-Resistance is <2.1 ratio, then Factor V (Leiden) Mutation Analysis will be performed at an additional charge (CPT code(s): 81241).
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).
Prothrombin (Factor II) 20210G→A Mutation Analysis
Antithrombin III Activity
Factor VIII Activity, Clotting
Hexagonal Phase Confirm
dRVVT Screen with Reflex to dRVVT Confirm and dRVVT 1:1 Mix
Cardiolipin Antibodies (IgG, IgM)
Beta-2-Glycoprotein I Antibodies (IgG, IgM)
If Activated Protein C-Resistance is <2.1 ratio, then Factor V (Leiden) Mutation Analysis will be performed at an additional charge (CPT code(s): 81241).
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 (x6) collected in 3.2% sodium citrate (light blue-top) tubes
1 mL frozen platelet-poor plasma (x6) collected in 3.2% sodium citrate (light blue-top) tubes
Minimum Volume
3 mL whole blood • 0.5 mL (x6) 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 approx. 1500 x g within 60 minutes of collection using a plastic pipette, remove plasma, taking care to avid the WBC/platelet buffy layer and place into a plastic vial. Centrifuge a second time and transfer platelet-poor plasma into 6 new plastic vials. Plasma must be free of platelets (<10,000/mcL). Freeze immediately and ship on dry ice.
Note: Storage of whole blood at refrigerated temperatures prior to processing may lead to cryoprecipitate formation and falsely low Factor VIII and von Willebrand Factor studies.
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?)
See individual assays
Methodology
Chromogenic • Immunoassay (IA) • Polymerase Chain Reaction and Detection • Clot Detection • dRVVT-based Clot Assay
Setup Schedule
Set up and Report available: See individual assays
Report Available
7 Days
Reference Range
See Laboratory Report
Clinical Significance
This panel evaluates for the most common hereditary and acquired venous thrombophilia risk factors except for Protein C and S.