Venous Thrombosis Hypercoagulability Panel with Reflex

Test Code

LAB5211978

Quest Code

11475

CPT Codes
85307, 81240, 85303, 85306, 85305, 85300, 86147 (x2), 85240, 86146 (x2), 85730, 85613

Includes

Activated Protein C Resistance with Reflex to Factor V (Leiden) Mutation
Prothrombin (Factor II) 20210G→A Mutation Analysis
Protein C Activity
Protein S Antigen, Total and Free
Antithrombin III Activity
Factor VIII Activity, Clotting
Lupus Anticoagulant Evaluation with Reflex (PTT-LA and dRVVT with Reflex Confirmations)
Cardiolipin Antibodies (IgG, IgM)
Beta-2-Glycoprotein I Antibodies (IgG, IgM)

If Activated Protein C-Resistance is <2.1 ratio, Factor V (Leiden) Mutation Analysis is performed at an additional charge (CPT code(s): 81241).

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 collected in each of six 3.2% sodium citrate (light blue-top) tubes

Minimum Volume

3 mL whole blood • 0.5 mL (x6) frozen platelet-poor plasma

Instructions

Whole blood sample is for the Factor V Mutation Analysis and Prothrombin (Factor II) Mutation Analysis.

Platelet-poor plasma is for 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 six 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

Specimen Stability

⁠⁠⁠⁠⁠⁠⁠Whole blood
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 tests

Methodology
Chromogenic Clotting Assay • Enzyme Immunoassay (EIA) • Immunoturbidimetric Immunoassay • Polymerase Chain Reaction and 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 FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Setup Schedule

See individual assays.

Reference Range

See Laboratory Report

Clinical Significance

This panel evaluates for the most common hereditary and acquired venous thrombophilia risk factors.

Performing Laboratory
Quest Diagnostics Nichols Institute
33608 Ortega Highway
San Juan Capistrano, CA 92675-2042

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.