Ordering Recommendation

Use for unexplained prolonged PTT or for patients with a significant probability of having antiphospholipid syndrome (APS).  For APS, order with Cardiolipin Antibodies, IgG and IgM (0099344) and Beta-2 Glycoprotein 1 Antibodies, IgG and IgM (anti-beta[2]GP1) (0050321).

Mnemonic
LUPUS R
Methodology

Electromagnetic Mechanical Clot Detection

Performed

Sun-Sat

Reported

1-2 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 2 mL platelet-poor plasma to an ARUP Standard Transport Tube. (Min: 2 mL)

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: 4 hours; Refrigerated: Unacceptable; Frozen at -20°C or below: 3 months; Frozen at -70°C or below: 18 months

Reference Interval

Effective August 21, 2017

Test Number
Components
Reference Interval
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
Prothrombin Time 12.0-15.5 seconds
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

Interpretive Data



Compliance Category

Laboratory Developed Test (LDT)

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 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.

Hotline History
N/A
CPT Codes

85610; 85730; 85613; if reflexed, additional CPT codes may apply: 85670; 85635; 85730; 85525; 85732; 85597; 85613; 85598.

Components
Component Test Code* Component Chart Name LOINC
0030079 Lupus Anticoagulant Interpretation 75882-1
0030082 Hexagonal Phospholipid Neutral Reflex 33930-9
0030084 PTT-D Heparin Neutralized 52123-7
0030184 Platelet Neutralization (PTT-D, Confirm) 15191-0
0030189 dRVVT Confirmation 50410-0
0030232 PTT-LA Screen (PTT-D) 34571-0
0030246 Prothrombin Time 5902-2
0030270 Thrombin Time 3243-3
0030296 Reptilase Time 6683-7
0030323 PTT-D 1:1 Mix 5946-9
0030352 dRVVT Screen 6303-2
0030353 dRVVT 1:1 Mix 75513-2
* 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
  • DRVVT
  • dRVVT 1:1 Mix
  • dRVVT Confirmation
  • dRVVT Screen
  • Hexagonal Phospholipid Neutral Reflex
  • Lupus 1
  • Lupus Anticoagulant
  • Lupus Anticoagulant Comprehensive
  • Lupus Anticoagulant with Reflex to Phospholipid Neutralization
  • Lupus Inhibitor
  • Platelet Neutralization
  • Prothrombin Time
  • PTT-D Heparin Neutralized
  • PTT-LA Screen
  • Reptilase Time
  • Thrombin Time
Lupus Anticoagulant Reflexive Panel