Venous Thrombosis Hypercoagulability Panel with Reflex (Warfarin Patient)

Test Code

11472

CPT Codes
85307, 81240, 85300, 86147 (x2), 85240, 86146 (x2), 85598, 85613

Includes

Activated Protein C Resistance with Reflex to Factor V (Leiden) Mutation
Prothrombin (Factor II) 20210G→A Mutation Analysis
Antithrombin III Activity
Factor VIII Activity, Clotting
Hexagonal Phase Confirm
dRVVT Screen with Reflex to dRVVT Confirm and dRVVT 1:1 Mix
Cardiolipin Antibodies (IgG, IgM)
Beta-2-Glycoprotein I Antibodies (IgG, IgM)

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

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 is for remaining tests.

Platelet-poor plasma: Centrifuge light blue-top tube 15 minutes at approx. 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 assays

Methodology
Chromogenic • Immunoassay (IA) • Polymerase Chain Reaction and Detection • Clot Detection • dRVVT-based Clot Assay

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

Clinical Significance

This panel evaluates for the most common hereditary and acquired venous thrombophilia risk factors except for Protein C and S.

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.