Thrombotic Risk (Acquired) Reflexive Panel
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
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: 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. EDTA plasma, 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 Components Reference Interval
0030057D-​Dimer 0.0-​0.4 µg/mL
0099869Homocysteine, Total Less than 11 µmol/L, for both male and female
 Prothrombin Time 12.0-​15.5 seconds
 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
 Partial Thromboplastin Time 32-​48 seconds
 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
 Hexagonal Phospholipid Neutralization Negative
0050901Cardiolipin Antibody, IgG Effective August 18, 2014
0-​14 GPL: Negative
15-​19 GPL: Indeterminate
20-​80 GPL: Low to Moderately Positive
81 GPL or above: High Positive
0050902Cardiolipin Antibody, IgM Effective August 18, 2014
0-​12 MPL: Negative
13-​19 MPL: Indeterminate
20-​80 MPL: Low to Moderately Positive
81 MPL or above: High 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.
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 Interpretation3281-3
0030082Hexagonal Phospholipid Neutral Reflex33930-9
0030084PTT-D Heparin Neutralized52122-9
0030184Platelet Neutralization (PTT-D, Confirm)3284-7
0030189dRVVT Confirmation52756-4
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 Mix43397-9
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
    Platelet Neutralization
  • Reptilase Time
  • Thrombin Time