Comprehensive Hypercoag Profile

Message
For Specimen Integrity during Extreme Weather see the “Lockbox Usage in Extreme Weather” document at the top of this page.

Patient must be at rest for 10 minutes before collection.

This test needs a completed Anticoagulant Drug List submitted with the specimen. For a copy of the 2 page form click here

If unable to process and properly store specimens within 4 hours of collection then call CompuNet transportation for a STAT pick-up at (937) 297-8262 option 1.


Test Code
CHYPER


Alias/See Also
74804


CPT Codes
85049; 85613; 85347; 85610; 85730(2); 86146(3); 86147(3); 86148(3); 86849; 85303; 85300; 85420; 85305; 85306; 83090; 81240; 81241; 85307 (Possible Reflex 85732(2); 85613; 85598; 85597; 85611; 85210; 85220; 85230; 85260; 85240; 85250; 85270)

Includes
Phospholipid Antibodies;
      Beta 2 Glycoprotein Abs IgG, IgM, IgA,
      Cardiolipin Abs IgG, IgM, IgA,
      Phosphatidylserine Abs IgG, IgM, IgA,
      Antiprothrombin Ab IgG
Protein C;
Antithrombin III (AT3);
Plasminogen;
APC Resistance
Lupus Anticoagulant Assay:
       Screening tests performed are Platelet Count, PT, APTT, DRVVT, Kaolin Clotting Time, PTT LA Screen and Thrombin Time. If any part of assay is abnormal then reflex testing is performed with additional charges.
Protein S Free and Total;
Homocysteine;
Prothrombin 20210G>A Gene Mutation;
Factor V Leiden


Preferred Specimen
2 K3EDTA (lavender top) tubes
2 SST (speckled top) tubes OR GST (gold top) tubes
8 plastic (2.7mL) completely filled 3.2% Sodium Citrate (light blue top) tubes


Patient Preparation
Patient must be at rest for 10 minutes before collection.

Minimum Volume
1 K3EDTA (lavender top) tube
3 Frozen Capped aliquots of at least 0.5mL serum (Polypropylene tubes recommended)
    AND
8 Frozen Capped aliquots of Sodium Citrate plasma (Polypropylene tubes recommended)


Instructions
Use standard venipuncture and disposal techniques.
Collect the required quantity of Sodium Citrate (light blue top) tubes.

If unable to process specimens within 4 hours of collection then call CompuNet transportation for a STAT pick-up at (937) 297-8262 option 1.

K3EDTA lavender tube:
Keep as whole blood (do not spin) and maintain at room temperature.

SST/GST tube: Avoid hemolysis.
1. Invert a minimum of 5 times, and then allow clotting in an upright position for 30 minutes.
2. Centrifuge the SST/GST for at 3000 rpm for 10 minutes.
3. Spun SST/GST tube remains at refrigerated temperature (2-8 degrees C) for transport up to 48 hours for Homocysteine and up to 72 hours for Phospholipid Antibodies (includes: Beta 2 Glycoprotein, Cardiolipin, Phosphatidylserine and Antiprothrombin)
4. Serum must be removed from original SST/GST tube and frozen at ≤-20 degrees C in plastic polypropylene aliquot tubes within 48 to 72 hours of collection depending on test. Refer to the Minimum Volume section above for the number of aliquots required per test.

Sodium Citrate (light blue top) tubes: Process immediately (stable only 4 hours), following instructions below:
Note: We recommend aliquot tubes to be made of polypropylene plastic as this material is safe to freeze at ≤-70 degrees C.
1. Centrifuge capped Sodium Citrate (light blue top) tubes at 3000 rpm for 10 minutes, or at speed and time required to consistently produce Platelet Poor Plasma (≤5/kmm3).
2. Carefully remove the plasma from all Sodium Citrate (light blue top) tubes; avoid disturbing the WBC/buffy coat, and combine all plasma into a plastic conical centrifuge tube.
Note: If the plasma shows any hemolysis, it must be recollected.
3. Centrifuge the plasma in the plastic conical centrifuge tube for a second time as in step 1.
4. In one smooth motion, carefully and quickly pour the centrifuged plasma into a second 15mL plastic conical centrifuge tube. A small amount of plasma along with a red cell button should remain on the bottom of the original conical tube if the pour was executed correctly. Note: This quick-pour method prevents platelet transfer and contamination.
5. Aliquot at least 1mL of plasma into each aliquot tubes labeled “plasma.” Refer to the Minimum Volume section above for the number of aliquots required per test.
6. Finally, place all aliquots into a <-20°C freezer within 4 hours.
Note: Aliquots must remain frozen until they are picked up by the CompuNet courier. Call CompuNet transportation department if frozen specimen boxes are needed.


Transport Container
K3EDTA lavender top tube(s)
SST (speckled top) tube or GST (gold top) tube(s)
Whole blood Sodium Citrate (light blue top) tubes
    OR
Frozen
- Capped aliquots of at least 0.5mL serum (Polypropylene tubes recommended)
Frozen- Capped aliquots of Sodium Citrate plasma (Polypropylene tubes recommended)


Transport Temperature
Room Temperature: K3EDTA lavender top tube(s)
                                 Whole blood


Specimen Stability
Room Temperature: K3EDTA (lavender top) tubes ≤ 24 hours for Lupus Anticoagulant Platelet Count and ≤ 7 days for Prothrombin 2021G>A                  
                                Whole blood Sodium Citrate (light blue top) tubes < 4 hours
Refrigerated: K3EDTA (lavender top) tubes ≤ 48 hours for Lupus Anticoagulant Platelet Count and 7 days for Prothrombin 2021G>A
                      SST (speckled top) tube or GST (gold top) tubes <48 hours for Homocysteine and <72hours Phospholipid             Antibodies                     
                     Unacceptable for Sodium Citrate (light blue top) tubes whole blood or capped plasma aliquots
Frozen: Capped aliquots of at least 0.5mL serum (Polypropylene tubes recommended): Homocysteine <13 weeks at<-20⁰C and Phospholipid Antibodies <13 months at <-20⁰C
             Capped aliquots of Sodium Citrate plasma (Polypropylene tubes recommended)<30 days at <-20⁰C


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Sodium Citrate Plasma: Rejected for hemolysis, clotted, improper fill, incorrect specimen type, thawed frozen aliquots, refrigerated plasma or blood, expired test tubes, >4 hours old if not processed into separated frozen plasma vials.

EDTA lavender top tube: Rejected for gross hemolysis and received frozen.

Serum: Hemolysis, Lipemia, incorrect specimen type, insufficient sample volume, improper storage conditions, exceeds specimen stability guidelines, contaminated sample.


Methodology
ELISA, clotting, chromogenic analysis, real-time PCR, immunoassay.

Setup Schedule
PRO 20210G>A & FAC V = MD = Monday - Friday
HOMOCY = CH= Daily
SCOAG= All remaining tests see individual tests for setup days


Report Available
1 - 6 days


Limitations
Anti-coagulant medications


Performing Laboratory
CompuNet Clinical Laboratories, LLC
2308 Sandridge Drive
Moraine, OH 45439


Last Updated: August 11, 2022


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.