Thrombophilia Panel 3 (Client 2170, 3788, 55114, 57947)

Test Code

9747CP

CPT Codes
85307, 85300, 85613, 81240, 85384, 83090, 83695, 85303, 85306, 85240

Includes

Activated Protein C-Resistance; Factor V (Leiden) Mutation Analysis; Antithrombin III Activity; dRVVT Screen; dRVVT Confirm; dRVVT 1:1 Mix; Prothrombin (Factor II) 20210G>A Mutation Analysis;
Fibrinogen Activity, Clauss; Homocysteine; Lipoprotein (a); Protein C Activity; Protein S Activity; Factor VIII Activity, Clotting
If dRVVT screen is prolonged (>45 seconds), the dRVVT Confirmation will be performed at an additional charge.
If dRVVT Confirm is positive, a dRVVT 1:1 dilution will be performed at an additional charge.

Preferred Specimen

8 mL plasma collected in a 3.2% sodium citrate (light blue-top) tube and 10 mL whole blood collected in an EDTA (lavender-top) tube and 2 mL plasma collected in an EDTA (lavender-top) tube

Minimum Volume

EDTA plasma: 1 mL
Whole blood: 5 mL
Citrated plasma: 4 mL

Instructions

See individual assays

Transport Temperature

Citrated plasma: Frozen
Whole blood: Room temperature
EDTA plasma: Refrigerated (cold packs)

Specimen Stability

Plasma
Room temperature: Unacceptable
Refrigerated: Unacceptable
Frozen: 14 Days
Whole blood
Room temperature: 8 Days
Refrigerated: 8 Days
Frozen: 30 days
Plasma
Room temperature: 4 Days
Refrigerated: 14 Days
Frozen: 90 Days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Hemolysis • Unseparated serum or plasma • Grossly lipemic

Methodology
See individual assays

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. The FDA has determined that such clearance or approval is not necessary. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Setup Schedule

See individual assays

Clinical Significance

See individual assays

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.