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

CLOT REF R

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

This test is New York DOH approved.

Specimen Required

Patient Preparation
Collect

At least five (5) Light Blue (Sodium Citrate) tubes. Refer to Specimen Handling at aruplab.com for hemostasis/thrombosis specimen handling guidelines.

Specimen Preparation

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)

Storage/Transport Temperature

CRITICAL FROZEN. Separate specimens must be submitted when additional test codes are ordered.

Unacceptable Conditions

Serum or EDTA plasma. Specimens containing anticoagulant medications. Clotted or hemolyzed specimens.

Remarks

Submit the Patient History Form for Prolonged Clot Reflex Panel.

Stability

Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: at -20°C: 3 months; Frozen at -70°C: 6 months

Reference Interval

Test Number
Components
Reference Interval
  Factor II, Activity (Prothrombin)
Age Reference Interval (%)
1-4 days 26-70
5-29 days 33-93
30-89 days 34-102
90-179 days 45-105
180-364 days 60-116
1-5 years 71-116
6 years 67-107
7-9 years 78-125
10-11 years 78-120
12-13 years 72-123
14-15 years 75-135
16-17 years 77-130
18 years and older 86-150

  Bethesda Quantitative, F8 0.5 BU or less
  Bethesda Quantitative, F9 0.4 BU or less
  D-Dimer 0.0-0.4 µg/mL
  Factor V, Activity
Age Reference Interval (%)
1-4 days 36-108
5-29 days 45-145
30-89 days 62-134
90-179 days 48-132
180-364 days 55-127
1-5 years 79-127
6 years 63-116
7-9 years 69-132
10-11 years 66-136
12-13 years 66-135
14-15 years 61-129
16-17 years 65-131
18 years and older 62-140

  Factor VII, Activity
Age Reference Interval (%)
1-4 days 28-104
5-29 days 35-143
30-89 days 42-138
90-179 days 39-143
180-364 days 47-127
1-5 years 55-116
6 years 52-120
7-9 years 67-145
10-11 years 71-163
12-13 years 78-160
14-15 years 74-180
16-17 years 63-163
18 years and older 80-181

  Hexagonal Phospholipid Neutral Reflex Negative
  PTT-D Heparin Neutralized 32-48 seconds
  Factor VIII, Activity
Age
Reference Interval (%)
0-6 years 56-191
7-9 years 76-199
10-11 years 80-209
12-13 years 72-198
14-15 years 69-237
16-17 years 63-221
18 years and older 56-191

  Factor IX, Activity
Age Reference Interval (%)
1-4 days 15-91
5-29 days 15-91
30-89 days 21-81
90-179 days 21-113
180-364 days 36-136
1-5 years 47-104
6 years 63-89
7-9 years 70-133
10-11 years 72-149
12-13 years 73-152
14-15 years 80-161
16-17 years 86-176
18 years and older 78-184

  Factor X, Activity
Age Reference Interval (%)
1-4 days 12-68
5-29 days 19-79
30-89 days 31-87
90-179 days 35-107
180-364 days 38-118
1-5 years 58-116
6 years 55-101
7-9 years 74-130
10-11 years 70-134
12-13 years 69-133
14-15 years 63-146
16-17 years 74-146
18 years and older 81-157

  Factor XI, Activity
Age Reference Interval (%)
1-4 days 10-66
5-29 days 23-87
30-89 days 27-79
90-179 days 41-97
180-364 days 38-134
1-5 years 56-150
6 years 52-120
7-9 years 70-138
10-11 years 66-137
12-13 years 68-138
14-15 years 57-129
16-17 years 65-159
18 years and older 56-153

  Factor XII, Activity 58-166%
  Soluble Fibrin Monomer Negative
  Fibrinogen 150-430 mg/dL
  Platelet Neutralization (PTT-D, Confirm) Negative
  dRVVT Confirmation Negative
  PTT-LA Screen (PTT-D) 32-48 seconds
  Prothrombin Time 12.0-15.5 seconds
  von Willebrand Factor, Activity (RCF)
Age
Reference Interval (%)
0-6 years 51-215
7-9 years 52-176
10-11 years 60-195
12-13 years 50-184
14-15 years 50-203
16-17 years 49-204
18 years and older 51-215

  Thrombin Time 14.7-19.5 seconds
  von Willebrand Factor, Antigen
Age
Reference Interval (%)
0-6 years 52-214
7-9 years 62-180
10-11 years 63-189
12-13 years 60-189
14-15 years 57-199
16-17 years 50-205
18 years and older 52-214

  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
  PT, Inhibitor Screen, 1:1 Mix 12.0-15.5 seconds

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.

Compliance Category

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

N/A

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 48065-7
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
* 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

Prolonged Clot Time Reflex Panel