Thrombotic Risk Reflexive Panel
Ordering Recommendation
Panel to evaluate for inherited and acquired thrombophilias.
Methodology
Chromogenic Assay/Electromagnetic Mechanical Clot Detection/Quantitative Enzymatic Assay/Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Polymerase Chain Reaction/Fluorescence Monitoring/Microlatex Particle-Mediated Immunoassay
Performed
Varies
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.
Four Light Blue (Sodium Citrate) AND two Lavender (EDTA) AND two Serum Separator Tubes (SST). Also acceptable in place of one of the Serum Separator Tubes (SST): Green (Sodium or Lithium Heparin) or EDTA (K2 or K3).
One Serum Separator Tube (SST), 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 Transfer 2 mL serum into 2 ARUP Standard Transport Tubes, label as serum. (Min: 0.5 mL/tube) AND Transfer 7.5 mL platelet poor plasma prepared from the sodium citrate tubes to 5 ARUP Standard Transport Tubes, label as sodium citrate. (Min: 1 mL/tube) AND Transfer 3 mL lavender whole blood to 2 ARUP Standard Transport Tubes. (Min: 1 mL/tube)
Light Blue (Sodium Citrate): CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered.
Lavender Whole Blood and Serum, Green (Sodium or Lithium Heparin) or EDTA (K2 or K3): Frozen.
Specimens collected in any tube type not listed above.
Light Blue (Sodium Citrate): Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 2 weeks
Lavender Whole Blood: Ambient: 7 days; Refrigerated: 1 week; Frozen: 1 month
Serum: Ambient: 2 hours; Refrigerated: 1 week; Frozen: 2 weeks
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 |
||||||||||||||||||||||||||||
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Antithrombin, Enzymatic (Activity) |
|
|||||||||||||||||||||||||||||
Hexagonal Phospholipid Neutral Reflex | Negative | |||||||||||||||||||||||||||||
PTT-D Heparin Neutralized | 32-48 seconds | |||||||||||||||||||||||||||||
Protein C Functional |
|
|||||||||||||||||||||||||||||
Platelet Neutralization (PTT-D, Confirm) | Negative | |||||||||||||||||||||||||||||
dRVVT Confirmation | Negative | |||||||||||||||||||||||||||||
APC Resistance | 2.00 or greater | |||||||||||||||||||||||||||||
PTT-LA Screen (PTT-D) | 32-48 seconds | |||||||||||||||||||||||||||||
Prothrombin Time | 12.0-15.5 seconds | |||||||||||||||||||||||||||||
Thrombin Time | 14.7-19.5 seconds | |||||||||||||||||||||||||||||
Reptilase Time | Less than 22.0 seconds | |||||||||||||||||||||||||||||
PTT-D 1:1 Mix | 32-48 seconds | |||||||||||||||||||||||||||||
dRVVT Screen | 33-44 seconds | |||||||||||||||||||||||||||||
dRVVT 1:1 Mix | 33-44 seconds | |||||||||||||||||||||||||||||
B2Glycoprotein 1, IgG Antibody | <=20 SGU | |||||||||||||||||||||||||||||
B2Glycoprotein 1, IgM Antibody | <=20 SMU | |||||||||||||||||||||||||||||
Cardiolipin Antibody IgG | 14 GPL or less | |||||||||||||||||||||||||||||
Cardiolipin Antibody IgM | 12 MPL or less | |||||||||||||||||||||||||||||
Homocysteine, Total | 0-15 µmol/L, for both male and female |
Interpretive Data
Refer to individual components.
This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.
Counseling and informed consent are recommended for genetic testing. Consent forms are available online.
Laboratory Developed Test (LDT)
Note
If APC resistance is normal, then Factor V Leiden by PCR will not 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
86147 x2; 86146 x2; 85306; 83090; 85300; 85303; 85307; 85610; 81240; 85730; 85613. If PTT is abnormal, add 85670. If Thrombin time is abnormal, add 85635, 85730 and 85525. If PTT Heparin Neutralization is abnormal, add 85732. If PTT 1:1 Mix is abnormal, add 85597. If dRVVT is abnormal, add 85613. If dRVVT 1:1 mix is abnormal, add 85613. If PNP and dRVVT confirmation are normal, add 85598. If APC resistance is low, add 81241.
Components
Component Test Code* | Component Chart Name | LOINC |
---|---|---|
0030010 | Antithrombin, Enzymatic (Activity) | 27811-9 |
0030054 | Thrombosis Interpretation - Risk | 48767-8 |
0030079 | Lupus Anticoagulant Interpretation | 75882-1 |
0030082 | Hexagonal Phospholipid Neutral Reflex | 33930-9 |
0030084 | PTT-D Heparin Neutralized | 52123-7 |
0030113 | Protein C Functional | 27819-2 |
0030184 | Platelet Neutralization (PTT-D, Confirm) | 15191-0 |
0030189 | dRVVT Confirmation | 50410-0 |
0030193 | APC Resistance | 13590-5 |
0030194 | Factor V Leiden by PCR | 21668-9 |
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 |
0050322 | B2Glycoprotein 1, IgG Antibody | 44448-9 |
0050323 | B2Glycoprotein 1, IgM Antibody | 44449-7 |
0050901 | Cardiolipin Antibody IgG | 3181-5 |
0050902 | Cardiolipin Antibody IgM | 3182-3 |
0056060 | Prothrombin (F2) G20210A Variant | 24475-6 |
0098894 | Protein S Ag Free | 27821-8 |
0099869 | Homocysteine, Total | 13965-9 |
2001308 | FACV REF Specimen | 31208-2 |
2001334 | PT PCR Specimen | 31208-2 |