Thrombotic Risk (Acquired) Reflexive Panel (INACTIVE as of 08/20/18)
Ordering Recommendation

Acceptable screening panel for acquired thrombophilia.

Electromagnetic Clot Detection/Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Immunoturbidimetry/Quantitative Enzymatic
1-4 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
Light blue (sodium citrate) for Lupus Anticoagulant Reflexive Panel and d-dimer (refer to the Specimen Handling at for hemostasis/thrombosis specimens handling guidelines) AND serum separator tube for cardiolipin AND serum separator tube OR green (sodium or lithium heparin) for homocysteine. 
Specimen Preparation
Transfer two 2 mL platelet-poor plasma (Min: 2 mL) AND 2 mL serum (Min: 0.6 mL) AND 1 mL serum or plasma (Min: 0.5 mL) to individual ARUP Standard Transport Tubes. 
Storage/Transport Temperature
For Lupus Anticoagulant Reflexive Panel (Plasma): CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered.
For Cardiolipin Antibodies (Serum): Refrigerated.
For Homocysteine (Serum or Plasma): Refrigerated. 
Unacceptable Conditions
For Lupus Anticoagulant Reflexive Panel (Plasma): Serum. EDTA plasma, clotted or hemolyzed specimens.
For Cardiolipin Antibodies (Serum):
Plasma and other body fluids, heat-inactivated, hemolyzed, lipemic, or contaminated specimens.
For Homocysteine (Serum or Plasma):
Sodium citrate. 
For Lupus Anticoagulant Reflexive Panel (Plasma): Ambient: 4 hours; Refrigerated: Unacceptable; Frozen: 1 week
For Cardiolipin Antibodies (Serum):
Ambient: 48 hours; Refrigerated: 2 weeks; Frozen 1 year (avoid repeated freeze/thaw cycles)
For Homocysteine (Serum or Plasma):
Ambient: 4 days; Refrigerated: 1 month; Frozen: 10 months 
Reference Interval
Test Number
Reference Interval
0030057D-Dimer0.0-0.4 µg/mL
0099869Homocysteine, TotalLess than 11 µmol/L, for both male and female
 Prothrombin Time12.0-15.5 seconds
 dRVVT Screen33-44 seconds
 dRVVT 1:1 Mix33-44 seconds
 dRVVT ConfirmationNegative
 PTT-LA Screen (PTT-D)32-48 seconds
 Thrombin Time14.7-19.5 seconds
 Reptilase TimeLess than 22.0 seconds
 PTT-D Heparin Neutralized32-48 seconds
 PTT-D 1:1 Mix32-48 seconds
 Platelet Neutralization (PTT-D, Confirm)Negative
 Hexagonal Phospholipid Neutral ReflexNegative
0050901Cardiolipin Antibody, IgGEffective August 18, 2014
0-14 GPLNegative
15-19 GPLIndeterminate
20-80 GPLLow to Moderately Positive
81 GPL or aboveHigh Positive

0050902Cardiolipin Antibody, IgMEffective August 18, 2014
0-12 MPLNegative
13-19 MPLIndeterminate
20-80 MPLLow to Moderately Positive
81 MPL or aboveHigh Positive

Interpretive Data
Refer to report.

If PTT and dRVVT are normal, then no further testing is performed. If PTT is abnormal, Thrombin Time is added. If Thrombin Time is normal, PTT 1:1 mix is added. If Thrombin time is abnormal, Reptilase Time and PTT Heparin Neutralization is added. If PTT Heparin Neutralization is abnormal, PTT 1:1 mix is added. If PTT 1:1 mix is abnormal, Platelet Neutralization procedure is added. If dRVVT is abnormal, dRVVT 1:1 mix is added. If dRVVT 1:1 mix is abnormal, dRVVT confirmation is added. If Platelet Neutralization procedure and dRVVT confirmation are normal or if one is normal and the other not done, Hexagonal Phospholipid Neutralization is added. Additional charges apply.
Hotline History
CPT Code(s)
85610; 85730; 85613; 86147 x2; 85379; 83090; if reflexed, additional CPT codes may apply: 85670; 85635; 85730; 85525; 85732; 85597; 85613 x2; 85598.
Component Test Code*Component Chart NameLOINC
0030079Lupus Anticoagulant Interpretation75882-1
0030082Hexagonal Phospholipid Neutral Reflex33930-9
0030084PTT-D Heparin Neutralized52123-7
0030184Platelet Neutralization (PTT-D, Confirm)15191-0
0030189dRVVT Confirmation50410-0
0030232PTT-LA Screen (PTT-D)34571-0
0030246Prothrombin Time5902-2
0030270Thrombin Time3243-3
0030296Reptilase Time6683-7
0030323PTT-D 1:1 Mix5946-9
0030352dRVVT Screen6303-2
0030353dRVVT 1:1 Mix75513-2
0050901Cardiolipin Antibody IgG3181-5
0050902Cardiolipin Antibody IgM3182-3
0099869Homocysteine, Total13965-9
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
  • aCL antibody
  • acquired thombotic risk panel
  • Cardiolipin Antibody
  • D-Dimer
  • dRVVT Screen
  • Hexagonal Phospholipid Neutral Reflex
  • Homocysteine, Total
  • Hypercoag
  • Hypercoagulable Panel
  • Lupus Anticoagulant Interpretation
  • Prothrombin Time
  • PTT-D Heparin Neutralized
  • Reptilase Time
  • Thrombin Time