Factor IX Activity, Clotting [352X]

Test Code
29133


CPT Codes
85250

Preferred Specimen
1 mL frozen platelet-poor plasma collected in a 3.2% sodium citrate (light blue-top) tube


Minimum Volume
0.5 mL


Instructions
Centrifuge light blue-top tube for 15 minutes at approximately 1500 g within 60 minutes of collection. Using a plastic pipette, remove plasma, take 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. Plasma must be free of platelets (<10,000/mcL). Freeze immediately and ship on dry ice.


Transport Container
Plastic screw-cap vial


Transport Temperature
Frozen 


Specimen Stability
Room temperature: Unacceptable
Refrigerated: Unacceptable
Frozen: 14 days


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Hemolysis • Received thawed


Methodology
Photometric Clot Detection

Setup Schedule
Set up: Mon-Fri; Report available: Next day


Limitations
Expected impact by therapeutic levels (potential interference depends upon drug concentration): Warfarin: Decrease; Heparin (UFH or LMWH): no effect to inhibitor pattern; Dabigatran or Argatroban (Thrombin Inhibitors): no effect to inhibitor pattern; Rivaroxaban or Apixaban (Factor Xa Inhibitors): no effect to inhibitor pattern.


Reference Range
60-160% normal


Clinical Significance
This test is useful to evaluate a prolonged aPTT. Deficiency of Factor IX can be seen with congenital deficiency (Hemophilia B, X-linked disorder) which affects approximately 1 in 25,000 males. As a vitamin K-dependent clotting factor, decreased levels are also observed with vitamin K antagonists (eg. warfarin therapy) and vitamin K deficiency. Deficiencies may be seen with liver disease, disseminated intravascular coagulation (DIC) and in other consumptive coagulopathies.

Anticoagulant interference: Expected impact by therapeutic levels (potential interference depends upon drug concentration): Warfarin: decrease; Heparin (UFH or LMWH): no effect to inhibitor pattern; Dabigatran or Argatroban (Thrombin Inhibitors): no effect to inhibitor pattern; Rivaroxaban, Apixaban, Edoxaban (Factor Xa Inhibitors): no effect to inhibitor pattern. Other limitations: Lupus anticoagulant may cause falsely low to inhibitor pattern. Factor specific inhibitors (autoantibodies or in response to replacement therapies) may cause falsely low or inhibitor patterns.


Performing Laboratory
Quest Diagnostics Nichols Institute
14225 Newbrook Drive
Chantilly, VA 20153




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.