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Thrombotic Risk Reflex Panel
Ordering Recommendation
Use to evaluate for inherited and acquired thrombophilias. For a list of components and reflex information, refer to the Additional Technical Information document.
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 one serum separator tube (SST).
Separate serum from cells ASAP or within 2 hours of collection. Transfer 1 mL serum into 1 ARUP standard transport tube, label as serum. (Min: 0.6 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: 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: After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)
Methodology
Electromagnetic Mechanical Clot Detection / Chromogenic Assay / Semi-Quantitative Enzyme-Linked Immunosorbent Assay (ELISA) / Polymerase Chain Reaction (PCR) / Fluorescence Monitoring / Microlatex Particle-Mediated Immunoassay
Performed
Varies
Reported
2-7 days
Reference Interval
Refer to report
Interpretive Data
Refer to individual components.
Laboratory Developed Test (LDT)
Note
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); and APC Resistance Profile with Reflex to Factor V Leiden (0030192).
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 greater than 30 seconds, then Hepzyme treatment is added. If PTT-LA Ratio is normal and Anti-Xa Qualitative Interpretation is Present, or Thrombin Time is greater than 30 seconds, and Anti-Xa Qualitative Interpretation is Not Present, or Thrombin Time is less than 30 seconds, 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.
Hotline History
Hotline History
CPT Codes
81240; 85300; 85303; 85306; 85307; 85610; 85613; 85730; 86147x2; 86146x2; if reflexed, additional CPT codes may apply: 81241; 85520; 85525; 85598; 85613; 85670; 85730.
Components
| Component Test Code* | Component Chart Name | LOINC |
|---|---|---|
| 3017158 | Thrombosis Interpretation - Risk | 48767-8 |
Aliases
- Hypercoag
- Hypercoagulable
