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
0030235 Partial Thromboplastin Time 24-35 seconds
0030215 Prothrombin Time 12.0-15.5 seconds
0030113 Protein C, Functional Effective November 17, 2014
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%

0098894 Protein S Free, Antigen
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%

0030010 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 years 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%

Interpretive Data

Refer to report.

No compliance statements are in use for this test.

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)