Fibrinolysis Comprehensive Panel

Test Code
90923

CPT Codes
85360, 85362 (x2), 85379, 85410, 85415 (x2), 85420

Includes
Alpha 2-Antiplasmin; D-Dimer, Quantitative; Euglobulin Clot Lysis Time; Fibrinogen Degradation Products (FDP), Semi Quantitative; Plasminogen Activator Inhibitor-1 (PAI-1); Plasminogen Activity; Tissue Plasminogen Activator (TPA), EIA; Fibrin Monomer

Preferred Specimen
Minimum: 1 mL (x4) frozen plasma collected in a 3.2% sodium citrate (light blue-top) tube

Patient Preparation
Morning fasting is required

Instructions
Platelet-poor plasma: Centrifuge (light blue-top) tube 15 minutes at approximately 1500 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. Avoid hemolysis. Avoid lipemia.

Transport Temperature
Frozen

Specimen Stability
Room temperature: Unacceptable
Refrigerated: Unacceptable
Frozen: 14 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Hemolysis • Lipemia • Contaminated plasma • Improperly stored or handled specimens • Received room temperature • Received refrigerated

Methodology
Chromogenic Assay • Clot Dissolution • Enzyme Immunoassay (EIA) • Hemagglutination (HA) • Latex Agglutination (LA)

Setup Schedule
Set up: See individual assay; Report Available: 5 days

Reference Range
See Laboratory Report

Clinical Significance
An increase in PAI-1 antigen is associated with an increased risk for post-operative venous thrombosis, myocardial infarction, and (probably) stroke. A severe deficiency of alpha-2 antiplasmin or PAI-1 antigen has been associated with bleeding. A shortened euglobulin lysis time correlates with a severe deficiency of alpha-2 antiplasmin or PAI-1 antigen. Elevations in fibrin monomer, fibrinogen degradation products, and D-dimer usually indicate vascular thrombosis (mainly venous) but are also associated with malignancy and infection. Conversely, a normal D-dimer and/or negative fibrin monomer suggests the absence of deep venous thrombosis and pulmonary emboli. Marked reduction in plasminogen has been associated with a prothrombotic state, and an elevated TPA level is a risk marker of coronary artery disease.

Performing Laboratory
Quest Diagnostics Nichols Inst San Juan Capistrano
33608 Ortega Highway
San Juan Capistrano, CA 92690-6130



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.