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Protein C and S Activity with Reflex to Antigen
Test Code7942
CPT Codes
85303, 85306
Includes
If Protein C Activity is <70%, then Protein C Antigen will be performed at an additional charge (CPT code(s): 85302).
If Protein S Activity is <70% for males or <60% for females, then Protein S Antigen will be performed at an additional charge (CPT code(s): 85305).
If Protein S Activity is <70% for males or <60% for females, then Protein S Antigen will be performed at an additional charge (CPT code(s): 85305).
Preferred Specimen
2 mL (x2) frozen plasma collected in 3.2% sodium citrate (light blue-top) tubes
Minimum Volume
1 mL
Instructions
Please submit a separate, frozen vial for each special coagulation assay ordered. Draw blood in a light blue-top tube containing 3.2% sodium citrate, mix gently by inverting 3-4 times. Centrifuge 15 minutes at 1500 g within one hour 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(s). Freeze immediately and transport on dry ice.
Transport Temperature
Frozen
Specimen Stability
Room temperature: Unacceptable
Refrigerated: Unacceptable
Frozen: 14 days
Refrigerated: Unacceptable
Frozen: 14 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Hemolysis
Methodology
See inidividual tests
Setup Schedule
See individual assays
Clinical Significance
Aids in characterization of protein C (PC) and/or protein S (PS) deficiency. PC and PS deficiency is associated with increased thrombotic risk and may be congenital or acquired. Acquired PC and PS deficiency may occur with vitamin K antagonists/deficiency, liver disease, malignancy, consumptive DIC, surgery, trauma, and hepatic immaturity of the newborn. In addition, PS deficiency is physiologic in pregnancy.
Anticoagulant interference: Expected impact by therapeutic levels (potential interference depends upon drug concentration): Warfarin: decrease; Heparin (UFH or LMWH): no effect to falsely increased activity levels at higher levels; Dabigatran or Argatroban (Thrombin Inhibitors): may falsely increase activity; Rivaroxaban, Apixaban, Edoxaban (Factor Xa Inhibitors): may falsely increase activity.
Anticoagulant interference: Expected impact by therapeutic levels (potential interference depends upon drug concentration): Warfarin: decrease; Heparin (UFH or LMWH): no effect to falsely increased activity levels at higher levels; Dabigatran or Argatroban (Thrombin Inhibitors): may falsely increase activity; Rivaroxaban, Apixaban, Edoxaban (Factor Xa Inhibitors): may falsely increase activity.
