Activated Protein C Resistance : 1002779

Message
The aliquot must remain frozen. Freeze thaw cycle will adversely affect specimen integrity. CRITICAL FROZEN: Separate specimens must be submitted when multiple tests are ordered.

Test Code
APCR or 1002779

Alias/See Also
APCR; Protein C Resistance V

CPT Codes
85307

Instructions
Blue top tube, 3.2% sodium citrate.
• Obtain venous blood by clean venipuncture. Avoid slow-flowing draws and/or traumatic venipunctures as either of these may result in an activated or clotted specimen. Do not use needles smaller than 23 gauge. Do not leave the tourniquet on for an extended length of time before drawing the sample.
• A pilot tube (non-additive or light blue tube) before drawing coagulation specimens in light blue vacuum tubes is only necessary when using a butterfly blood collection set as this will cause reduced draw volume in the first tube. Discard the pilot tube.
• Fill light blue tubes as far as vacuum will allow and mix by gentle inversion. Exact ratio of nine parts blood to one part anticoagulant must be maintained. Inadequate filling of the sample tube will alter this ratio and may lead to inaccurate results. Patients who have hematocrit values above 55 percent should have the anticoagulant adjusted to maintain the 9:1 ratio. Use the following formula to determine the amount of anticoagulant to use: [(100 – Hct) / (595 – Hct) ]* total volume = amount of anticoagulant required.
• After collecting the blood, examine the tube to ensure that it is filled to within 90% of the fill line.
• Note: Specimens containing heparin should not be used for coagulation studies. If possible, stop heparin therapy before the draw to avoid contamination. Heparin interferes with most clotting assays. If heparinized line must be used to obtain the sample, flush line with 5mL saline and discard the first 5 mL of blood drawn into a syringe, or 6 “dead space” volumes of the line.

Transport Container
Centrifuge the blue top tube at a rate of speed to yield platelet poor plasma (<10,000 /uL), immediately remove only the top two-thirds of the platelet-poor plasma from the specimen using a plastic-transfer pipet (use of glass-transfer pipets may result in activation and/or clotting of the plasma) and transfer citrated plasma (Min. 0.5 mL) into a standard transport tube, and freeze the aliquot.

Transport Temperature
Frozen.

Specimen Stability
Ambient:  Whole blood 4 hours; After separation from cells: Refrigerated: 4 hours; Frozen: 2 weeks

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Tubes not filled within 90% of the fill line will be rejected by the lab.

Methodology
Clotting

Setup Schedule
Monday & Thursday

Report Available
1-5 days

Reference Range
>2.21

Clinical Significance
APC resistance is a thrombotic risk factor caused by the factor V Leiden mutation that is found in 3 to 8% of Caucasians. The APC resistance assay may be performed as a screen before ordering the confirmatory factor V Leiden mutation assay. Greater than 90% of patients with a positive APCR screening assay have a specific mutation in the coagulant factor V gene (Factor V Leiden mutation).

Performing Laboratory
med fusion



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.