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Prolonged Clot Time Reflex Panel
2014318
Ordering Recommendation

Determine the cause for a prolonged prothrombin time or partial thromboplastin time. Condition-specific testing is recommended if the cause for the prolonged clotting time is known. 

Mnemonic
CLOT REF R
Methodology
Electromagnetic Mechanical Clot Detection/Qualitative Hemagglutination/Platelet Agglutination/Microlatex Particle-Mediated Immunoassay
Performed
Mon-Sun
Reported
1-8 days
New York DOH Approval Status
This test is New York DOH approved.
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
 
Collect
At least five (5) Light Blue (Sodium Citrate) tubes. Refer to Specimen Handling at aruplab.com for hemostasis/thrombosis specimen handling guidelines. 
Specimen Preparation
Transfer five 1 mL aliquots of platelet-poor plasma to five ARUP Standard Transport Tubes, label as sodium citrate. (Min: 1 mL/aliquot and 5 mL total) 
Storage/Transport Temperature
CRITICAL FROZEN. Separate specimens must be submitted when additional test codes are ordered. 
Unacceptable Conditions
Serum or EDTA plasma. Specimens containing anticoagulant medications. Clotted or hemolyzed specimens. 
Remarks
Submit the Patient History Form for Prolonged Clot Reflex Panel. 
Stability
Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: at -20°C: 3 months; Frozen at -70°C: 6 months 
Reference Interval
Test Number
Components
Reference Interval
0030130Fibrinogen150-430 mg/dL
0030057D-Dimer0.0-0.4 µg/mL
0030181Lupus Anticoagulant Reflexive PanelEffective August 21, 2017
Test Number
Components
Reference Interval
Dilute Russell Viper Venom Time (dRVVT)33-44 seconds
Dilute Russell Viper Venom (dRVVT) 1:1 Mix (performed if dRVVT > 44 seconds)33-44 seconds
Dilute Russell Viper Venom Time (dRVVT) Confirmation Test (performed if dRVVT 1:1 Mix > 44 seconds)Negative
Prothrombin Time12.0-15.5 seconds
Partial Thromboplastin Time32-48 seconds
Thrombin Time14.7-19.5 seconds
Reptilase TimeLess than 22.0 seconds
PTT Heparin Neutralized32-48 seconds
Partial Thromboplastin Time 1:1 Mix (performed if PTT > 48 seconds)32-48 seconds
Platelet Neutralization Procedure (performed if PTT 1:1 Mix > 48 seconds)Negative
Hexagonal Phospholipid NeutralizationNegative

PT, Inhibitor Screen, 1:1 Mix12.0-15.5 seconds
0030126Soluble Fibrin MonomerNegative
0030007Factor II, Activity (Prothrombin)
AgeReference IntervalAgeReference Interval
1-4 days26-70%7-9 years78-125%
5-29 days33-93%10-11 years78-120%
30-89 day34-102%12-13 years72-123%
90-179 days45-105%14-15 years75-135%
180-364 days60-116%16-17 years77-130%
1-5 years71-116%18 years and older86-150%
6 years67-107%

0030075Factor V, Activity
AgeReference IntervalAgeReference Interval
1-4 days36-108%7-9 years69-132%
5-29 days45-145%10-11 years66-136%
30-89 days62-134%12-13 years66-135%
90-179 days48-132%14-15 years61-129%
180-364 days55-127%16-17 years65-131%
1-5 years79-127%18 years and older62-140%
6 years63-116%

0030080Factor VII, Activity
AgeReference IntervalAgeReference Interval
1-4 days28-104%7-9 years67-145%
5-29 days35-143%10-11 years71-163%
30-89 days42-138%12-13 years78-160%
90-179 days39-143%14-15 years74-180%
180-364 days47-127%16-17 years63-163%
1-5 years55-116%18 years and older80-181%
6 years52-120%

0030026Factor VIII Activity with Reflex to Bethesda Quantitative, Factor VIII
Test Number
Components
Reference Interval
0030095Factor VIII, ActivityRefer to report
Bethesda Quantitative, Factor VIIIEffective May 19, 2014
0.5 BU or less

0030032Factor IX Activity with Reflex to Bethesda Quantitative, Factor IX
Test Number
Components
Reference Interval
0030100Factor IX, ActivityRefer to report
Bethesda Quantitative, Factor IXEffective May 19, 2014
0.4 BU or less

0030105Factor X, Activity
AgeReference IntervalAgeReference Interval
1-4 days12-68%7-9 years74-130%
5-29 days19-79%10-11 years70-134%
30-89 days31-87%12-13 years69-133%
90-179 days35-107%14-15 years63-146%
180-364 days38-118%16-17 years74-146%
1-5 years58-116%18 years and older81-157%
6 years55-101%

0030110Factor XI, Activity
AgeReference IntervalAgeReference Interval
1-4 days10-66%7-9 years70-138%
5-29 days23-87%10-11 years66-137%
30-89 days27-79%12-13 years68-138%
90-179 days41-97%14-15 years57-129%
180-364 days38-134%16-17 years65-159%
1-5 years56-150%18 years and older56-153%
6 years52-120%

0030115Factor XII, Activity58-166%
0030285von Willebrand Factor Antigen
AgeReference Interval
0-6 years52-214%
7-9 years62-180%
10-11 years63-189%
12-13 years60-189%
14-15 years57-199%
16-17 years50-205%
18 years and older52-214%

0030250von Willebrand Factor Activity (Ristocetin Cofactor)
AgeReference Interval
0-6 years51-215%
7-9 years52-176%
10-11 years60-195%
12-13 years50-184%
14-15 years50-203%
16-17 years49-204%
18 years and older51-215%


Interpretive Data
Refer to report.

Note
Submission of a completed Patient History Form with test order will allow for optimal panel interpretation. The Patient History Form for Prolonged Clot Reflex Panel is available on the ARUP web site or by contacting ARUP Client Services at (800) 522-2787. 

If D-Dimer is abnormal, Soluble Fibrin Monomer is added. If PT is abnormal PT, Inhibitor Screen, 1:1 Mix is added. 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. Depending on findings, one or more reflexive tests may be required in order to provide a clinical interpretation. Additional charges apply.
CPT Code(s)
85384, 85379, 85610, 85730, 85613; if reflexed, additional CPT codes may apply: 85670, 85635, 85730, 85525, 85732,
85597, 85613, 85598, 85611, 85366, 85210, 85220, 85230, 85240, 85335, 85250, 85260, 85270, 85280, 85246, 85245
Components
Component Test Code*Component Chart NameLOINC
0030007Factor II, Activity (Prothrombin)3289-6
0030028Bethesda Quantitative, F83204-5
0030033Bethesda Quantitative, F93185-6
0030057D-Dimer7799-0
0030075Factor V, Activity3193-0
0030079Lupus Anticoagulant Interpretation75882-1
0030080Factor VII, Activity3198-9
0030082Hexagonal Phospholipid Neutral Reflex33930-9
0030084PTT-D Heparin Neutralized52123-7
0030095Factor VIII, Activity3209-4
0030100Factor IX, Activity3187-2
0030105Factor X, Activity3218-5
0030110Factor XI, Activity3226-8
0030115Factor XII, Activity3232-6
0030126Soluble Fibrin Monomer40702-3
0030130Fibrinogen3255-7
0030184Platelet Neutralization (PTT-D, Confirm)3284-7
0030189dRVVT Confirmation57838-5
0030232PTT-LA Screen (PTT-D)34571-0
0030246Prothrombin Time5902-2
0030250von Willebrand Factor, Activity (RCF)6014-5
0030270Thrombin Time3243-3
0030285von Willebrand Factor, Antigen27816-8
0030296Reptilase Time6683-7
0030323PTT-D 1:1 Mix5946-9
0030352dRVVT Screen6303-2
0030353dRVVT 1:1 Mix75513-2
2003265PT, Inhibitor Screen, 1:1 Mix33357-5
2014319Prolonged Clot Time Reflex Panel Interp48767-8
* 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.
Aliases