Thrombotic Risk, Inherited Etiologies (Most Common) with Reflex to Factor V Leiden (Change effective as of 02/21/23: Refer to 0030095, 0030192, 0030235, 0056060, 0099869)
Ordering Recommendation
Acceptable screening panel for common inherited thrombophilias.
Mnemonic
Methodology
Electromagnetic Mechanical Clot Detection/Quantitative Enzymatic Assay/Polymerase Chain Reaction/Fluorescence Monitoring
Performed
Sun-Sat
Reported
2-7 days
New York DOH Approval Status
Specimen Required
Fasting preferred. Refer to Specimen Handling at aruplab.com for hemostasis/thrombosis specimen handling guidelines.
Lt. blue (sodium citrate) AND lavender (EDTA) or pink (K2EDTA) AND serum separator tube, green (sodium or lithium heparin), or EDTA (K2 or K3).
Serum Separator Tube, Green (sodium or lithium heparin), or EDTA (K2 or K3) must be centrifuged and serum or plasma separated within 1 hour of collection. Transfer 1 mL centrifuged serum or plasma to ARUP Standard Transport Tube and label centrifuged tube for homocysteine testing. (Min: 0.5 mL) AND Transport two 2 mL aliquots platelet-poor plasma (sodium citrate) (Min: 1 mL/aliquot) AND Transport 5 mL whole blood (EDTA). (Min: 1 mL)
Light blue (sodium citrate): CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered.
Lavender whole blood and Serum or Green (sodium or lithium heparin): Frozen.
Specimens collected in any tube type not listed above and frozen specimens in glass collection tubes.
Light blue (sodium citrate): Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 2 weeks
Lavender whole blood: Ambient: 7 days; Refrigerated: 1 week; Frozen: 1 month
Serum, Green (sodium or lithium heparin), or EDTA (K2 or K3): Ambient: 4 days; Refrigerated: 1 month; Frozen: 10 months
Reference Interval
Test Number |
Components |
Reference Interval |
||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Partial Thromboplastin Time | 24-35 seconds | |||||||||||||||||
Factor VIII, Activity |
|
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Homocysteine, Total | 0-15 µmol/L, for both male and female | |||||||||||||||||
APC Resistance | 2.00 or greater |
Interpretive Data
Ratios less than 2.00 suggest APC resistance. This method uses factor V deficient plasma; therefore, APC resistance due to a nonfactor V mutation will not be detected. Extreme factor V deficiency or presence of direct oral anticoagulants (DOACs) may cause an unreliable ratio. Elevated total homocysteine (tHcy) concentrations may be associated with vitamin B12 deficiency, folate deficiency, or inherited disorders of methionine metabolism. tHcy may also be used as a weak-graded risk factor for cardiovascular disease or stroke.
FDA
Note
If APC resistance is normal, then no further testing will be added. If APC resistance is low, or if a valid result cannot be obtained for the APC portion of the profile, then Factor V Leiden by PCR will be added. Additional charges apply. False elevations of plasma or serum homocysteine may occur if the plasma or serum is not promptly separated from the cells at the time of collection.
Hotline History
Hotline History
CPT Codes
85730; 85240; 83090; 81240; 85307; if reflexed, add 81241
Components
Component Test Code* | Component Chart Name | LOINC |
---|---|---|
0030052 | Thrombosis Interpretation | 48767-8 |
0030095 | Factor VIII, Activity | 3209-4 |
0030193 | APC Resistance | 13590-5 |
0030194 | Factor V Leiden by PCR | 21668-9 |
0030235 | Partial Thromboplastin Time | 14979-9 |
0056060 | Prothrombin (F2) G20210A Variant | 24475-6 |
0099869 | Homocysteine, Total | 13965-9 |
2001308 | FACV REF Specimen | 31208-2 |
2001334 | PT PCR Specimen | 31208-2 |
Aliases
- Activated Protein C Resistance
- APC Resistance
- APCR
- F2 G20210A mutation
- F8 Activity
- Factor V Leiden
- Factor V Leiden Functional Assay
- Factor V Leiden PCR
- Factor VIII, Activity
- FVL
- Hypercoag
- Hypercoagulable Panel
- Protein C Resistance
- Prothrombin mutation
- prothrombin time
- PTT
- total homocyteine