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Prolonged aPTT Bleeding Evaluation [19644X]
Test Code18181
CPT Codes
85730
Includes
Partial Thromboplastin Time, Activated (aPTT)
Impression
If the baseline aPTT is minimally prolonged, then test Minimally Prolonged aPTT Profile (includes Factors VIII, IX, XI, VWF Antigen, Ristocetin Cofactor Activity) will be performed at an additional charge (CPT code(s): 85384, 85610, 85670, 85246, 85245).
If the baseline aPTT is prolonged, then aPTT 1:1 mixing study progressive will be performed at an additional charge (CPT code(s): 85732).
If a correction pattern is observed with the aPTT mixing study, then Factor VIII, IX and XI Activities will be performed at additional charge (CPT code(s): 85240, 85240, 85270).
If an inhibitor pattern is observed with the aPTT mixing study, then the Hexagonal Phase Confirm (CPT code(s): 85598) and Thrombin Time (CPT code(s): 85670) are performed at an additional charge.
Additional assays, as necessary will be performed at an additional charge to determine the cause of the abnormality.
Impression
If the baseline aPTT is minimally prolonged, then test Minimally Prolonged aPTT Profile (includes Factors VIII, IX, XI, VWF Antigen, Ristocetin Cofactor Activity) will be performed at an additional charge (CPT code(s): 85384, 85610, 85670, 85246, 85245).
If the baseline aPTT is prolonged, then aPTT 1:1 mixing study progressive will be performed at an additional charge (CPT code(s): 85732).
If a correction pattern is observed with the aPTT mixing study, then Factor VIII, IX and XI Activities will be performed at additional charge (CPT code(s): 85240, 85240, 85270).
If an inhibitor pattern is observed with the aPTT mixing study, then the Hexagonal Phase Confirm (CPT code(s): 85598) and Thrombin Time (CPT code(s): 85670) are performed at an additional charge.
Additional assays, as necessary will be performed at an additional charge to determine the cause of the abnormality.
Preferred Specimen
1 mL platelet-poor plasma collected in each of four 3.2% sodium citrate (light blue-top) tubes
Minimum Volume
0.5 mL (x4)
Instructions
4 mL citrated platelet poor plasma, frozen.
Submit 4 plasma aliquots, each with 1 mL plasma for possible additional testing.
Refer to Quest Diagnostics Nichols Institute Directory of Services under Specimen Collection section, Coagulation Testing for further information on specimen processing.
Submit 4 plasma aliquots, each with 1 mL plasma for possible additional testing.
Refer to Quest Diagnostics Nichols Institute Directory of Services under Specimen Collection section, Coagulation Testing for further information on specimen processing.
Transport Container
Transport tubes (x4)
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?)
Specimens received room temperature • Received refrigerated • Hemolysis
Methodology
Clotting Assay • Electrophoresis
Setup Schedule
Set up: Mon-Sat; Report available: 1-2 days
Reference Range
See Laboratory Report
Clinical Significance
This evaluation is for the patient with a prolonged Activated Prolonged Thromboplastin Time with a history of bleeding/bruising. The investigation follows a testing algorithm with an endpoint of arriving at a final diagnosis, most commonly a factor deficiency or von Willebrands disease.
Performing Laboratory
Quest Diagnostics Nichols Institute
14225 Newbrook Drive
Chantilly, VA 20153