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.

Specimen Required

Patient Preparation
Collect

Light 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
  Partial Thromboplastin Time 24-35 seconds
  Prothrombin Time 12.0-15.5 seconds
  Protein C Functional
Age Reference Interval (%)
1-4 days 17-53
5-29 days 20-64
30-89 days 21-65
90-179 days 28-80
180-364 days 37-81
1-6 years 40-92
7-9 years 70-142
10-11 years 68-143
12-13 years 66-162
14-15 years 69-170
16-17 years 70-171
18 years and older 83-168

  Antithrombin, Enzymatic (Activity)
Age Reference Interval (%)
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 yeas 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

  Protein S Ag Free
Age Male (%) Female (%)
1-89 days 15-55 15-55
90-179 days 35-92 35-92
180-364 days 45-115 45-115
1-5 years 62-120 62-120
6-9 years 62-130 62-130
10-17 years 60-140 60-140
18 years and older 74-147 55-123

Interpretive Data

Refer to report.

Compliance Category

FDA

Note

Hotline History

N/A

CPT Codes

85610; 85730; 85303; 85306; 85300

Components

Component Test Code* Component Chart Name LOINC
0030010 Antithrombin, Enzymatic (Activity) 27811-9
0030053 Thrombosis Interpretation - Uncommon 20991-6
0030113 Protein C Functional 27819-2
0030220 Prothrombin Time 5902-2
0030235 Partial Thromboplastin Time 14979-9
0098894 Protein S Ag Free 27821-8
* 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
Thrombotic Risk, Inherited Etiologies (Uncommon)