Ordering Recommendation

Panel to evaluate for inherited and acquired thrombophilias.

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation

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 (SSTs). Also acceptable in place of one of the serum separator tubes (SSTs): green (sodium or lithium heparin) or EDTA (K2 or K3).

Specimen Preparation

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)

Storage/Transport Temperature

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.

Unacceptable Conditions

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


Electromagnetic Mechanical Clot Detection/Chromogenic Assay/Quantitative Enzymatic Assay/Semi-Quantitative Enzyme-Linked Immunosorbent Assay (ELISA)/Polymerase Chain Reaction (PCR)/Fluorescence Monitoring/Microlatex Particle-Mediated Immunoassay




2-7 days

Reference Interval

Refer to individual components.

Interpretive Data

Refer to individual components.

Compliance Category

Laboratory Developed Test (LDT)


Testing will include Antithrombin, Enzymatic (Activity) (0030010); Protein S Free, Antigen (0098894); Protein C, Functional (0030113); Beta-2 Glycoprotein 1 Antibodies, IgG and IgM (0050321); Cardiolipin Antibodies, IgG and IgM (0099344); Lupus Anticoagulant Reflex Panel (3017009); Prothrombin (F2) c.*97G>A (G20210A) Pathogenic Variant (0056060); APC Resistance Profile with Reflex to Factor V Leiden (0030192); and Homocysteine, Total (0099869).

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.

For the Lupus Anticoagulant Reflex Panel (3017009) portion of the panel, if PTT-LA Ratio and dRVVT Screen Ratio are normal, then no further clot-based testing is performed. If either the PTT-LA Ratio or dRVVT Screen Ratio are elevated, then Anti-Xa Qualitative Interpretation is added. If PTT-LA Ratio is elevated, then Thrombin Time is also added. If Anti-Xa Qualitative Interpretation is Present and Thrombin Time is elevated, then Hepzyme treatment is added. If PTT-LA Ratio is normal and Anti-Xa Qualitative Interpretation is Present, or Thrombin Time is abnormal and Anti-Xa Qualitative Interpretation is Not Present, or Thrombin Time is normal and Anti-Xa Qualitative Interpretation is Present, then DOAC-Stop treatment is added. If either Hepzyme or DOAC-Stop treatment is added, then Neutralized PTT-LA Ratio and/or Neutralized dRVVT Screen Ratio are added. If dRVVT Screen Ratio is elevated in the absence of Hepzyme or DOAC-Stop, or if Neutralized dRVVT Screen Ratio is elevated, then dRVVT 1:1 Mix Ratio and dRVVT Confirmation Ratio are added. If PTT-LA Ratio is elevated in the absence of Hepzyme or DOAC-Stop treatment, or if Neutralized PTT-LA Ratio is elevated, then Hexagonal Phospholipid Confirmation is 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


CPT Codes

81240; 83090; 85300; 85303; 85306; 85307; 85610; 85613; 85730; 86147x2; 86146x2; if reflexed, additional CPT codes may apply: 81241; 85520; 85525; 85598; 85613; 85670; 85730.


Component Test Code* Component Chart Name LOINC
3017158 Thrombosis Interpretation - Risk 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.


Thrombotic Risk Reflex Panel