Ordering Recommendation

Preferred initial panel when antiphospholipid syndrome (APS) is strongly suspected.

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation
Collect

Light blue (sodium citrate) AND serum separator tube (SST). Refer to Specimen Handling at aruplab.com for hemostasis/thrombosis specimen handling guidelines.

Specimen Preparation

Transport 2 mL platelet poor plasma in an ARUP standard transport tube. (Min: 2 mL)
AND transport 1 mL serum in an ARUP standard transport tube. (Min: 0.6 mL)

Storage/Transport Temperature

Plasma: CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered.
Serum: Frozen.

Unacceptable Conditions

For Lupus Anticoagulant Reflexive Panel (Plasma): Serum. EDTA plasma, clotted or hemolyzed specimens.
For cardiolipin and beta-2 glycoprotein antibodies (serum): Plasma and other body fluids, heat-inactivated, hemolyzed, lipemic, or contaminated specimens.

Remarks
Stability

Plasma: Ambient: 4 hours; Refrigerated: Unacceptable; Frozen at -20 C or below: 3 months
Serum: 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)

Performed

Sun-Sat

Reported

1-3 days

Reference Interval

Interpretive Data

See individual components.

Compliance Category

Modified FDA

Note

Testing will include Beta-2 Glycoprotein 1 Antibodies, IgG and IgM (0050321); Cardiolipin Antibodies, IgG and IgM (0099344); and Lupus Anticoagulant Reflex Panel (3017009).

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

N/A

CPT Codes

85610; 85613; 85730; 86147x2; 86146x2; if reflexed, additional CPT codes may apply: 85520; 85525; 85598; 85613; 85670; 85730.

Components

Component Test Code* Component Chart Name LOINC
3017163 Testing Summary 75882-1
* 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

  • ACA
  • aCL antibody
  • Anti-Phospholipid Syndrome Reflexive Panel (Antiphospholipid Syndrome Reflexive Panel)
  • APS panel
  • APS Reflexive Panel
  • B2Glycoprotein I
  • B2GPI
  • Cardiolipin Antibody
  • dRVVT Screen
  • Hexagonal Phospholipid Neutral Reflex
  • Hughes Syndrome Panel
  • Hypercoag
  • Hypercoagulable
  • Lupus Anticoagulant (LA)
  • Platelet Neutralization
  • Prothrombin Time
  • PTT-D Heparin Neutralized
  • Thrombin Time
Antiphospholipid Syndrome Reflex Panel