Lupus Anticoagulant Assay W/Reflex testing to Confirm

Message
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.

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

Test Code
70911

CPT Codes
85049; 85613; 85347; 85610; 85730(2) (Possible Reflex 85732(2); 85613; 85598; 85597; 85611; 85210; 85220; 85230; 85260; 85240; 85250; 85270)

Includes
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.

Preferred Specimen
1 EDTA (lavender top) tubes
3 plastic (2.7mL) completely filled 3.2% Sodium Citrate (light blue top) tubes

Minimum Volume
1 EDTA (lavender top) tube
3 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.

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

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
EDTA lavender top tube(s)
Whole blood Sodium Citrate (light blue top) tubes
    OR
Frozen
- Capped aliquots of Sodium Citrate plasma (Polypropylene tubes recommended)

Transport Temperature
Room Temperature: EDTA lavender top tube(s)
                                 Whole blood Sodium Citrate (light blue top) tubes
Refrigerated: Unacceptable for Sodium Citrate (light blue top) tubes whole blood or capped plasma aliquots
Frozen: Capped aliquots of Sodium Citrate plasma (Polypropylene tubes recommended)

Specimen Stability
Room Temperature: EDTA (lavender top) tubes ≤ 24 hours
                                 Whole blood Sodium Citrate (light blue top) tubes < 4 hours
Refrigerated: EDTA (lavender top) tubes ≤ 48 hours
                      Unacceptable for Sodium Citrate (light blue top) tubes whole blood or capped plasma aliquots
Frozen: Capped aliquots of Sodium Citrate plasma (Polypropylene tubes recommended) <30 days at <-20⁰C
                                                                                                                                             or 6 months at <-70⁰C

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.

Methodology
Clotting

Setup Schedule
Monday and Thursday
SCOAG

Report Available
1 - 6 days

Limitations
Anti-coagulant medications and Hemolysis

Clinical Significance
Lupus Anticoagulants are acquired circulating inhibitors, usually IgG immunoglobulin, but sometimes IgM or IgA. Due to the wide variability of phospholipid activity among patients, there is no single test that will detect the presence of Lupus Anticoagulants. Therefore, multiple assays using reagents with varying amounts of phospholipids are used to detect the presence of Lupus Anticoagulants. Venous as well as arterial thrombosis may occur in patients with Lupus Anticoagulants. Lupus Anticoagulant antibodies occur in various clinical conditions, including autoimmune diseases, unexplained thrombosis and recurrent spontaneous abortions and fetal demise.

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



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.