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Prolonged Clot Time Reflex Panel
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Ordering Recommendation
Determine the cause for a prolonged prothrombin time or activated partial thromboplastin time. Condition-specific testing is preferred when the patient has a known coagulation disorder or a clear bleeding presentation.
Mnemonic
Methodology
Electromagnetic Mechanical Clot Detection/Qualitative Hemagglutination/Platelet Agglutination/Microlatex Particle-Mediated Immunoassay
Performed
Mon-Sun
Reported
1-8 days
New York DOH Approval Status
Specimen Required
At least five (5) Light Blue (Sodium Citrate) tubes. Refer to Specimen Handling at aruplab.com for hemostasis/thrombosis specimen handling guidelines.
Transfer five 1 mL aliquots of platelet-poor plasma to five ARUP Standard Transport Tubes, label as sodium citrate. (Min: 1 mL/aliquot and 5 mL total)
CRITICAL FROZEN. Separate specimens must be submitted when additional test codes are ordered.
Serum or EDTA plasma. Specimens containing anticoagulant medications. Clotted or hemolyzed specimens.
Submit the Patient History Form for Prolonged Clot Reflex Panel.
Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: at -20°C: 3 months; Frozen at -70°C: 6 months
Reference Interval
| Test Number |
Components |
Reference Interval |
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|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 0030130 | Fibrinogen | 150-430 mg/dL | ||||||||||||||||||||||||||||||||||||
| 0030057 | D-Dimer | 0.0-0.4 µg/mL | ||||||||||||||||||||||||||||||||||||
| 0030181 | Lupus Anticoagulant Reflexive Panel | Effective August 21, 2017
|
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| PT, Inhibitor Screen, 1:1 Mix | 12.0-15.5 seconds | |||||||||||||||||||||||||||||||||||||
| 0030126 | Soluble Fibrin Monomer | Negative | ||||||||||||||||||||||||||||||||||||
| 0030007 | Factor II, Activity (Prothrombin) |
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| 0030075 | Factor V, Activity |
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| 0030080 | Factor VII, Activity |
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| 0030026 | Factor VIII Activity with Reflex to Bethesda Quantitative, Factor VIII |
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| 0030032 | Factor IX Activity with Reflex to Bethesda Quantitative, Factor IX |
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| 0030105 | Factor X, Activity |
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| 0030110 | Factor XI, Activity |
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| 0030115 | Factor XII, Activity | 58-166% | ||||||||||||||||||||||||||||||||||||
| 0030285 | von Willebrand Factor Antigen |
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| 0030250 | von Willebrand Factor Activity (Ristocetin Cofactor) |
|
Interpretive Data
Refer to report.
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.
Laboratory Developed Test (LDT)
Note
Submission of a completed Patient History Form with test order will allow for optimal panel interpretation. The Patient History Form for Prolonged Clot Reflex Panel is available on the ARUP web site or by contacting ARUP Client Services at (800) 522-2787.
If D-Dimer is abnormal, Soluble Fibrin Monomer is added. If PT is abnormal PT, Inhibitor Screen, 1:1 Mix is added. 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. Depending on findings, one or more reflexive tests may be required in order to provide a clinical interpretation. Additional charges apply.
Hotline History
CPT Codes
85384, 85379, 85610, 85730, 85613; if reflexed, additional CPT codes may apply: 85670, 85635, 85730, 85525, 85732,
85597, 85613, 85598, 85611, 85366, 85210, 85220, 85230, 85240, 85335, 85250, 85260, 85270, 85280, 85246, 85245
Components
| Component Test Code* | Component Chart Name | LOINC |
|---|---|---|
| 0030007 | Factor II, Activity (Prothrombin) | 3289-6 |
| 0030028 | Bethesda Quantitative, F8 | 3204-5 |
| 0030033 | Bethesda Quantitative, F9 | 3185-6 |
| 0030057 | D-Dimer | 7799-0 |
| 0030075 | Factor V, Activity | 3193-0 |
| 0030079 | Lupus Anticoagulant Interpretation | 75882-1 |
| 0030080 | Factor VII, Activity | 3198-9 |
| 0030082 | Hexagonal Phospholipid Neutral Reflex | 33930-9 |
| 0030084 | PTT-D Heparin Neutralized | 52123-7 |
| 0030095 | Factor VIII, Activity | 3209-4 |
| 0030100 | Factor IX, Activity | 3187-2 |
| 0030105 | Factor X, Activity | 3218-5 |
| 0030110 | Factor XI, Activity | 3226-8 |
| 0030115 | Factor XII, Activity | 3232-6 |
| 0030126 | Soluble Fibrin Monomer | 40702-3 |
| 0030130 | Fibrinogen | 3255-7 |
| 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 |
| 0030250 | von Willebrand Factor, Activity (RCF) | 6014-5 |
| 0030270 | Thrombin Time | 3243-3 |
| 0030285 | von Willebrand Factor, Antigen | 27816-8 |
| 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 |
| 2003265 | PT, Inhibitor Screen, 1:1 Mix | 33357-5 |
| 2014319 | Prolonged Clot Time Reflex Panel Interp | 48767-8 |
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