| A B C D E F G H I J K L M N O P Q R S T U V W X Y Z # |
Prothrombin (G20210A) Gene Mutation
MessagePerformed by the Hematology/Special Coagulation Laboratory x5475, 76
Test Code
PT MU PCR
CPT Codes
81240
Preferred Specimen
whole blood
Minimum Volume
2 mL
Instructions
Some insurance companies require prior authorization before this test will be performed . A prior authorization letter will be emailed to the ordering physician to notify them that a form must be filled out and submitted.
For Tufts Health Plan, Network Health and Senior Whole Health patients:
Fill out the Molecular Testing Authorization Form (link below) to obtain the prior authorization number required or notify the laboratory if you no longer want this test to be run.
For United Health patients, complete the following form:
See helpful information below for the form:
Lab NPI #: 1730132515
Special Coagulation Lab Phone Number: 617-636-5475 or 76
Special Coagulation Lab Fax Number: 617-636-1042
CPT code for Prothrombin Gene Mutation: 81240
CPT code for F-V Leiden: 81241
Samples will be held for 14 days.
For Tufts Health Plan, Network Health and Senior Whole Health patients:
Fill out the Molecular Testing Authorization Form (link below) to obtain the prior authorization number required or notify the laboratory if you no longer want this test to be run.
https://tuftshealthplan.com/documents/providers/forms/genetic-and-molecular-diagnostic-testing
For United Health patients, complete the following form:
https://www.uhcprovider.com/en/prior-auth-advance-notification/genetic-molecular-lab.html
See helpful information below for the form:
Lab NPI #: 1730132515
Special Coagulation Lab Phone Number: 617-636-5475 or 76
Special Coagulation Lab Fax Number: 617-636-1042
CPT code for Prothrombin Gene Mutation: 81240
CPT code for F-V Leiden: 81241
Samples will be held for 14 days.
Transport Container
Light Blue Top (Sodium Citrate), 1.8 or 2.7 mL draw
Transport Temperature
Room Temperature
Specimen Stability
Refrigerated up to 15 days, frozen at -70 C for 1 month
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Wrong collection container (anticoagulant). Gross hemolysis
Methodology
Molecular assay by Real-time PCR
Setup Schedule
1x/week. Turnaround time is 10 days.
Reference Range
Negative for mutation. Report will indicate if the patient is negative, heterozygous, or homozygous for the mutation.
Clinical Significance
To detect the substitution of Adenine for guanine at nucleotide position 20210. Testing should be initiated in individuals with the following: Venous thrombosis or pulmonary embolism, Premature stroke or myocardial infarction, History of recurrent pregnancy loss or stillbirth or a Family history of thrombosis or known mutation in a relative .
