Thrombotic Risk (Acquired) Reflexive Panel
0030268
Ordering Recommendation
Acceptable screening panel for acquired thrombophilia.
Submit With Order
Mnemonic
HYPERCOAG
Methodology
Electromagnetic Clot Detection/Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Immunoturbidimetry/Quantitative Enzymatic
Performed
Sun-Sat
Reported
1-8 days
New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
Patient Preparation
 
Collect
Light blue (sodium citrate) for Lupus Anticoagulant Reflexive Panel and d-dimer (refer to the Specimen Handling at aruplab.com 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: 1.5 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 and non-sodium citrate plasma.
For Cardiolipin Antibodies (Serum): Plasma and other body fluids, heat-inactivated, hemolyzed, lipemic, or contaminated specimens.
For Homocysteine (Serum or Plasma): Sodium citrate.  
Remarks
 
Stability
For Lupus Anticoagulant Reflexive Panel (Plasma): Ambient: 4 hours; Refrigerated: 4 hours; 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 Components Reference Interval
Prothrombin Time 12.0-​15.5 seconds
Partial Thromboplastin Time 32-​48 seconds
Dilute Russell Viper Venom Time (dRVVT) 33-​44 seconds
0050901Cardiolipin Antibody, IgG 0-​14 GPL: Negative
15-​19 GPL: Indeterminate
20-​80 GPL: Low to Medium positive
81 GPL or above: High positive
0050902Cardiolipin Antibody, IgM 0-​12 MPL: Negative
13-​19 MPL: Indeterminate
20-​80 MPL: Low to Medium Positive
81 MPL or above: High positive
0030057D-​Dimer 0.0-​0.4 µg/mL
0099869Homocysteine, Total Less than 11 µmol/L, for both male and female
Thrombin Time 14.7-​19.5 seconds
Reptilase Time Less than 22.0 seconds
PTT Heparin Neutralized 32-​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
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
Hexagonal Phospholipid Neutralization Negative
Interpretive Data
Refer to report.
Note
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.
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.
Components
Component Test Code*Component Chart Name
0030057D-Dimer
0030079Lupus Anticoagulant Interpretation
0030082Hexagonal Phospholipid Neutral Reflex
0030084PTT-D Heparin Neutralized
0030184Platelet Neutralization (PTT-D, Confirm)
0030189dRVVT Confirmation
0030232PTT-LA Screen (PTT-D)
0030246Prothrombin Time
0030270Thrombin Time
0030296Reptilase Time
0030323PTT-D 1:1 Mix
0030352dRVVT Screen
0030353dRVVT 1:1 Mix
0050901Cardiolipin Antibody IgG
0050902Cardiolipin Antibody IgM
0099869Homocysteine, Total
* 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.
Cross References
  • 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
    Platelet Neutralization
  • Reptilase Time
  • Thrombin Time