Antiphospholipid Syndrome Reflexive Panel
2003222
Ordering Recommendation
Preferred initial panel for strong suspicion of antiphospholipid syndrome (APS).
Mnemonic
PHOS SYN
Methodology
Clotting/Semi-Quantitative Enzyme-Linked Immunosorbent Assay
Performed
Sun-Sat
Reported
1-2 days  
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
Specimen Required
Patient Preparation
  
Collect
Light blue (sodium citrate) for Lupus Anticoagulant Reflexive Panel (refer to the Specimen Handling at aruplab.com for hemostasis/thrombosis specimens handling guidelines) AND serum separator tube for cardiolipin and beta-2 glycoprotein antibodies.  
Specimen Preparation
Transport 2 mL platelet poor plasma. (Min: 1 mL) AND 1 mL serum (Min: 0.6 mL) in two separate ARUP Standard Transport Tubes.  
Storage/Transport Temperature
Plasma: CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered.
Serum: Refrigerated  
Unacceptable Conditions
For Lupus Anticoagulant Reflexive Panel (Plasma): Serum and non-sodium citrate plasma.
For cardiolipin and beta-2 glycoprotein antibodies (Serum): Plasma and other body fluids, heat-inactivated, hemolyzed, lipemic, or contaminated specimens.  
Remarks
  
Stability
For Lupus Anticoagulant Reflexive Panel (Plasma): Ambient: 4 hours; Refrigerated: 24 hours; Frozen: 1 week;
For cardiolipin and beta-2 glycoprotein antibodies (Serum): Ambient: 48 hours; Refrigerated: 2 weeks; Frozen 1 year (avoid repeated freeze/thaw cycles).  
Reference Interval
 
 
Available Separately Components Reference Interval
No Beta-​2 Glycoprotein 1 Antibody, IgG Effective February 18, 2014
0-​20 SGU
No Beta-​2 Glycoprotein 1 Antibody, IgM Effective February 18, 2014
0-​20 SMU
Yes (0050901) Cardiolipin 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
Yes (0050902) Cardiolipin 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
Yes (0030215) Prothrombin Time Effective February 18, 2014
12.0-​15.5 seconds
Yes (0030235) Partial Thromboplastin Time Effective February 18, 2014
32-​48 seconds
No Dilute Russell Viper Venom Time (dRVVT) Effective February 18, 2014
33-​44 seconds
No Thrombin Time Effective February 18, 2014
14.7-​19.5 seconds
No Reptilase Time Effective February 18, 2014
Less than 22.0 seconds
No PTT Heparin Neutralized Effective February 18, 2014
32-​48 seconds
No Partial Thromboplastin Time 1:1 Mix (performed if PTT >48 seconds) Effective February 18, 2014
32-​48 seconds
No Platelet Neutralization Procedure (performed if PTT 1:1 Mix >48 seconds) Effective February 18, 2014
Negative
No Dilute Russell Viper Venom (dRVVT) 1:1 Mix (performed if dRVVT >44 seconds) Effective February 18, 2014
33-​44 seconds
No Dilute Russell Viper Venom Time (dRVVT) Confirmation Test (performed if dRVVT 1:1 Mix >44 seconds) Effective February 18, 2014
Negative
No Hexagonal Phospholipid Neutralization Effective February 18, 2014
Negative
Interpretive Data
See individual components.  
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 are 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)
86147 x2; 86146 x2; 85610; 85730; 85613; if reflexed, additional CPT codes may apply: 85670; 85635; 85730; 85525; 85732; 85597; 85613 x2; 85598.
Components
Component Test Code*Component Chart Name
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
0050322B2Glycoprotein 1, IgG Antibody
0050323B2Glycoprotein 1, IgM Antibody
0050901Cardiolipin Antibody IgG
0050902Cardiolipin Antibody IgM
* 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
  • ACA
  • aCL antibody
  • Anti-Phospholipid Syndrome Reflexive Panel (Antiphospholipid Syndrome Reflexive Panel)
  • APS panel
  • APS Reflexive Panel
  • B2Glycoprotein I
  • B2GPI
  • Cardiolipin Antibody
  • dRVVT Screen
  • Hexagonal Phospholipid Neutral Reflex
  • Hughes Syndrome Panel
  • Hypercoag
  • Hypercoagulable
  • Lupus Anticoagulant (LA)
  • Platelet Neutralization
  • Prothrombin Time
  • PTT-D Heparin Neutralized
  • Reptilase Time
  • Thrombin Time