Thrombotic Risk Reflexive Panel
Ordering Recommendation

Panel to evaluate for inherited and acquired thrombophilias.

Chromogenic Assay/Electromagnetic Mechanical Clot Detection/Quantitative Enzymatic/Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Polymerase Chain Reaction/Fluorescence Monitoring/Microlatex Particle Mediated Immunoassay
2-7 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
Fasting preferred. Refer to Specimen Handling at for hemostasis/thrombosis specimen handling guidelines. 
Four light blue (sodium citrate) AND two lavender (EDTA) AND two serum separator tubes (SST). Also acceptable in place of one of the serum separator tubes: Green (sodium or lithium heparin). 
Specimen Preparation
One serum separator tube or green (sodium or lithium heparin) must be centrifuged and serum or plasma separated within 1 hour of collection. Transfer 1 mL centrifuged serum or plasma to ARUP Standard Transport Tube and label centrifuged tube for homocysteine testing. (Min: 0.5 mL) AND Transfer 2 mL serum into 2 ARUP Standard Transport Tubes, label as serum (Min: 0.5 mL/tube) AND Transfer 7.5 mL light blue (sodium citrate) to 5 ARUP Standard Transport Tubes, label as sodium citrate. (Min: 1 mL/tube) AND Transfer 3 mL lavender whole blood to 2 ARUP Standard Transport Tubes. (Min: 1 mL/tube 
Storage/Transport Temperature
Light blue (sodium citrate): CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered. Lavender whole blood and Serum or Green (sodium or lithium heparin): Refrigerated. 
Unacceptable Conditions
Specimens collected in any tube type not listed above. 
Light blue (sodium citrate): Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 2 weeks. Lavender whole blood: Ambient: 2 hours; Refrigerated: 1 week; Frozen: Unacceptable   Serum: Ambient: 2 hours; Refrigerated: 1 week; Frozen: 2 weeks Green (sodium or lithium heparin): Ambient: 1 hour; Refrigerated: 1 week; Frozen: 3 months 
Reference Interval
Test Number
Reference Interval
 Prothrombin Time12.0-15.5 seconds
Partial Thromboplastin Time32-48 seconds
 dRVVT Screen33-44 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
 dRVVT 1:1 Mix33-44 seconds
 dRVVT ConfirmationNegative
 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

 B2Glycoprotein 1, IgG AntibodyEffective August 18, 2014
0-20 SGU
 B2Glycoprotein 1, IgM AntibodyEffective August 18, 2014
0-20 SMU
0098894Protein S Free, Antigen
1-89 days15-55%15-55%
90-179 days35-92%35-92%
180-364 days45-115%45-115%
1-5 years62-120%62-120%
6-9 years62-130%62-130%
10-17 years60-140%60-140%
18 years and older74-147%55-123%

0099869Homocysteine, TotalLess than 11 µmol/L, for both male and female
0030010Antithrombin, Enzymatic (Activity)
AgeReference Interval
1-4 days39-87%
5-29 days41-93%
30-89 days48-108%
90-179 days73-121%
180-364 days84-124%
1-5 years82-139%
6 years90-131%
7-9 years90-135%
10-11 years90-134%
12-13 years90-132%
14-15 years90-131%
16-17 years87-131%
18 years and older76-128%

0030113Protein C, FunctionalEffective November 17, 2014
AgeReference Interval
1-4 days17-53%
5-29 days20-64%
30-89 days21-65%
90-179 days28-80%
180-364 days37-81%
1-6 years40-92%
7-9 years70-142%
10-11 years68-143%
12-13 years66-162%
14-15 years69-170%
16-17 years70-171%
18 years and older83-168%

 APC ResistanceEffective February 21, 2011

2.00 or greater
Test Number
Reference Interval
0030127APC Resistance PanelRefer to report
0097720Factor V Leiden (F5) R506Q MutationRefer to report

 Factor V Leiden by PCRNegative: The sample is negative for factor V Leiden, R506Q mutation.
0056060Prothrombin (F2) c.*97G>A (G20210A) Pathogenic Variant

Interpretive Data
Refer to individual components.

Compliance Statement C: For human genetic inheritable conditions and mutations. This test was developed and its performance characteristics determined by ARUP Laboratories. The U. S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.

Counseling and informed consent are recommended for genetic testing. Consent forms are available online.

Hotline History
View Hotline History
CPT Code(s)
86147 x2; 86146 x2; 85306; 83090; 85300; 85303; 85307; 85610; 81240; 85730; 85613.  If PTT is abnormal, add 85670. If Thrombin time is abnormal, add 85635, 85730 and 85525. If PTT Heparin Neutralization is abnormal, add 85732. If PTT 1:1 Mix is abnormal, add 85597.  If dRVVT is abnormal, add 85613.  If dRVVT 1:1 mix is abnormal, add 85613.  If PNP and dRVVT confirmation are normal, add 85598.  If APC resistance is low, add 81241.
Component Test Code*Component Chart NameLOINC
0030010Antithrombin, Enzymatic (Activity)27811-9
0030054Thrombosis Interpretation - Risk
0030079Lupus Anticoagulant Interpretation75882-1
0030082Hexagonal Phospholipid Neutral Reflex33930-9
0030084PTT-D Heparin Neutralized52123-7
0030113Protein C Functional27819-2
0030184Platelet Neutralization (PTT-D, Confirm)15191-0
0030189dRVVT Confirmation50410-0
0030193APC Resistance13590-5
0030194Factor V Leiden by PCR21668-9
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
0050322B2Glycoprotein 1, IgG Antibody44448-9
0050323B2Glycoprotein 1, IgM Antibody44449-7
0050901Cardiolipin Antibody IgG3181-5
0050902Cardiolipin Antibody IgM3182-3
0056060Prothrombin (F2) G20210A Variant24475-6
0098894Protein S Ag Free27821-8
0099869Homocysteine, Total13965-9
2001308FACV REF Specimen31208-2
2001334PT PCR Specimen31208-2
* 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.