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Recurrent Miscarriage Evaluation/Coagulation Panel with Consultation
Test CodeCPT Codes
83090, 85300, 85303, 85306, 85613, 85730, 83516 (x2), 86146 (x3), 86147 (x3), 81240, 81241, 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
Protein C Activity
Protein S Antigen, Free
Antithrombin III Activity
Cardiolipin Antibodies (IgA, IgG, IgM)
Beta-2-Glycoprotein I Antibodies (IgG, IgA, IgM)
Phosphatidylserine/Prothrombin (PS/PT) Antibodies (IgG, IgM)
Homocysteine
Prothrombin (Factor II) 20210G→A Mutation Analysis
Factor V (Leiden) Mutation Analysis
Coagulation Consultation
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
2 mL frozen platelet-poor plasma (x4) collected in separate 3.2% sodium citrate (light blue-top) tubes, and
3 mL serum collected in a red-top tube (no gel)
Minimum Volume
Instructions
•Whole blood sample is for the Factor V Mutation Analysis and Prothrombin (Factor II) Mutation Analysis.
•Serum sample is for the Homocysteine.
•Platelet-poor plasma is for the remaining tests.
Red top tubes: Place the specimen in a refrigerator or ice bath for 30 minutes after collection. Centrifuge the specimen as soon as possible after complete clot formation has taken place. Transfer the serum to a plastic screw-capped vial.
Barrier gel separator tubes: Place the specimen in a refrigerator for 30 minutes after collection. Centrifuge the specimen as soon as possible after complete clot formation has taken place. Do not place barrier tubes in an ice bath as freezing may prevent the barrier gel from adequately separating serum from cells.
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 transport on dry ice.
Serum and Plasma must remain frozen during storage and shipment. All requests for coagulation assays should include a brief patient history and other pertinent clinical information.
Transport Temperature
Plasma and serum: Frozen
Specimen Stability
Room temperature: 8 days
Refrigerated: 8 days
Frozen: 30 days
Plasma
Room temperature: Unacceptable
Refrigerated: Unacceptable
Frozen: 14 days
Serum
Room temperature: 4 days
Refrigerated: 14 days
Frozen: 6 months
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Methodology
Chromogenic • Clotting Assay • Enzyme Immunoassay (EIA) • Immunoassay (IA) • Immunoturbidimetric • Polymerase Chain Reaction & Detection
FDA Status
*This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.
Setup Schedule
Reference Range
Clinical Significance
