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Thrombotic Risk, Inherited Etiologies (Uncommon)
0030177
Ordering Recommendation

Acceptable panel to screen for uncommon inherited thrombophilias.

Mnemonic
THROMUNCOM
Methodology
Electromagnetic Clot Detection/Microlatex Particle-Mediated Immunoassay/Chromogenic Assay
Performed
Mon-Sat
Reported
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
 
Collect
Lt. blue (sodium citrate). Refer to Specimen Handling at aruplab.com for hemostasis/thrombosis specimen handling guidelines. 
Specimen Preparation
Transfer two 2 mL aliquots of platelet-poor plasma to ARUP Standard Transport Tubes. (Min: 1 mL/aliquot) 
Storage/Transport Temperature
CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered. 
Unacceptable Conditions
Serum EDTA plasma, clotted or hemolyzed specimens. 
Remarks
 
Stability
Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 1 month 
Reference Interval
Test Number
Components
Reference Interval
0030235Partial Thromboplastin Time24-35 seconds
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%

0098894Protein S Free, Antigen
AgeMaleFemale
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%

0030010Antithrombin, Enzymatic (Activity)1-4 days: 39-87%
5-29 days: 41-93%
30-89 days: 48-108%
90-179 days: 73-121%
180-364 days: 84-124%
1-5 years: 82-139%
6 years:  90-131%
7-9 years:  90-135%
10-11 years: 90-134%
12-13 years: 90-132%
14-15 years: 90-131%
16-17 years: 87-131%
18 years and older: 76-128%

Interpretive Data
Refer to report.

Note
CPT Code(s)
85610; 85730; 85303; 85306; 85300
Components
Component Test Code*Component Chart NameLOINC
0030010Antithrombin, Enzymatic (Activity)27811-9
0030053Thrombosis Interpretation - Uncommon20991-6
0030113Protein C Functional27819-2
0030220Prothrombin Time5902-2
0030235Partial Thromboplastin Time14979-9
0098894Protein S Ag Free27821-8
* 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
  • Antithrombin, Enzymatic (Activity)
  • Hypercoag
  • Hypercoagulable Panel, Inherited Etiologies (Uncommon)
  • Partial Thromboplastin Time
  • Protein C Functional
  • Protein S Ag Free
  • Prothrombin Time
  • Thrombophilia
  • Thrombosis Interpretation – Uncommon