Thrombophilia Panel

Test Code

14934

CPT Codes
81240, 81241, 83090, 85300, 85303, 85306, 85613, 85730, 86147 (x3)

Includes

7079 - Lupus Anticoagulant Evaluation with Reflex
1777 - Protein C, Activity
17909 - Prothrombin(Factor II) 20210G>A Mutation Analysis
1779 - Protein S, Activity
216 - Antithrombin III Activity
7352 - Cardiolipin Ab (IgA, IgG, IgM)
17900 - Factor V (Leiden) Mutation
31789 - Homocysteine

Reflex Criteria:
If dRVVT screen is prolonged (> 45 seconds), dRVVT Confirmation will be added at an additional charge (CPT code(s): 85597).

If the dRVVT Confirm is positive, a dRVVT 1:1 dilution will be added at an additional charge (CPT code(s): 85613).

If PTT-LA Screen is prolonged (> 40 seconds), then Hexagonal Phase Confirmation will be performed at an additional charge (CPT code(s): 85598).

If the Hexagonal Phase Confirm is positive or weakly positive a Thrombin Clotting Time will be performed at an additional charge. (CPT code(s):85670).

Preferred Specimen

Please see the individual tests for specimen requirements and stabilities.

Methodology
Chromogenic • Clotting Assay • Enzyme Immunoassay • Fluorescence Polarization Immunoassay • Polymerase Chain Reaction & Detection • Clot Detection

Setup Schedule

Set up and Report available: See individual assays

Reference Range

See individual tests

Clinical Significance

PTT-LA Screen: For additional information, please refer to http://education.questdiagnostics.com/faq/FAQ01v2 (This link is being provided for informational/educational purposes only.)

Cardiolipin Ab (IgM): The antiphospholipid antibody syndrome (APS) is a clinical-pathologic correlation that includes a clinical event (e.g. arterial or venous thrombosis, pregnancy morbidity) and persistent positive antiphospholipid antibodies (IgM, IgG Cardiolipin or b2GPI antibodies greater than the 99th percentile; or a lupus anticoagulant). International consensus guidelines for APS suggest waiting at least 12 weeks before retesting to confirm antibody persistence. The Systemic Lupus International Collaborating Clinics immunological classification criteria for systemic lupus erythematosus (SLE) include testing for isotype IgA, which has yet to be incorporated into APS criteria. Low level antiphospholipid antibodies may sometimes be detected in the setting of infection, drug therapy or aging.

For additional information, please refer to http://education.questdiagnostics.com/faq/FAQ109 (This link is being provided for informational/educational purposes only.)

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.