Sign in →

Test Code BLOD1448 (COUMADIN) Thrombotic Risk Panel with Reflex-Coumadin

Important Note

Special Handling Required.  Please draw the following:

  • 5 blue
  • 1 gold
  • 1 light-green (lithium heparin) on ice

Specimen must arrive and be tested within 4 hours of draw.  Heparin or Coumadin can affect certain coagulation factor assays, preclude their performance, or cause spurious results. Note that patient is on Heparin or Coumadin therapy when ordering test.

Profile Information

Test Code:

Name:

Methodology

Available Separately

Always Performed

BLOD0663

Antithrombin III Activity

Chromogenic

Yes

Yes

BLOD0364

PT G20210A Gene Mutation

PCR

Yes

Yes

BLOD0379

Factor V Leiden Mutation Analysis

PCR

Yes

Yes

BLOD0661

Factor VIII (8) Assay

Clot-Based Assay

Yes

Yes

BLOD0579

Homocysteine

Chemiluminescence

Yes

Yes

BLOD0670

DRVVT (Lupus-Like Anticoagulant)

Photometric

Yes

Yes

LABS0236

Lupus Inhibitor Screen (PTT)

Photometric

No

Yes

BLOD0297

Cardiolipin IgA

ELISA

Yes

Yes

BLOD0298

Cardiolipin IgG

ELISA

Yes

Yes

BLOD0299

Cardiolipin IgM

ELISA

Yes

Yes

BLOD1188

Beta-2 Glycoprotein 1 IgA

ELISA

Yes

Yes

BLOD1332

Beta-2 Glycoprotein 1 IgG

ELISA

Yes

Yes

BLOD1333

Beta-2 Glycoprotein 1 IgM

ELISA

Yes

Yes

BLOD1449

Protein C Antigen/Factor VII Antigen Ratio

ELISA

Yes

Yes

BLOD1450

Protein S Antigen/Factor VII Antigen Ratio

ELISA

Yes

Yes

BLOD0669

Protime/INR

Photo-Optical

Yes

Yes

PATH1014

Pathologist Interpretation

Manual

No

Yes

 

Reflex Tests

Epic

Test Code

Test Name

Performing Laboratory

Available Separately

Always Performed

BLOD0222

Antithrombin Antigen

Mayo Medical Laboratories

Yes

No

LABS0126

DRVV Confirm

Bozeman Health Laboratory Services

No

No

LABS0212

PTT Mixing Study

Bozeman Health Laboratory Services

Yes

No

BLOD0672

Thrombin Time

Bozeman Health Laboratory Services

Yes

No

Testing Algorithm:

If antithrombin III Activity is decreased, then antithrombin III antigen will be performed at an additional charge.
If lupus-like anticoagulant is increased, then confirmatory testing will be performed at an additional charge.
If PTT is increased, then mixing studies will be performed at an additional charge.

Performing Laboratory

Bozeman Health Laboratory Services/Mayo Medical Laboratories/Esoterix Laboratory Services

Specimen Requirements

Specimen must arrive and be tested within 4 hours of draw. The following specimens are required:

 

Specimen Type: Platelet-Poor Citrated Plasma
Container/Tube: Blue top (3.2% sodium citrate)

Specimen Volume:  4 Full tubes

Collection Instructions: Click here to link to a You Tube video tutorial

1. Immediately after draw, invert tubes several times to mix blood with additive.

2. Send specimen in original tube at ambient temperature.

3. If there is a delay in transport of >4 hours, specimen must be double-centrifuged to prepare a platelet-free plasma specimen as follows:

a. Immediately centrifuge at 3,200 rpm for 15 minutes.

b. Carefully remove plasma from cells avoiding platelet/buffy coat, and transfer plasma into a plastic tube.

c. Centrifuge plastic tube at 3,200 rpm for 15 minutes.

d. Carefully remove top portion of plasma and transfer plasma into a plastic tube leaving approximately 250 mcL in bottom to discard.

e. Double-centrifuged plasma should be aliquoted (0.5 mL-1 mL each) into clearly labeled plastic tubes. (Glass vial is not acceptable.)

Note: Number of tests ordered will determine number of aliquots needed, generally 1 aliquot per test.

f. Specimens should be frozen at <-40° C, if possible, and sent together in same container with at least 5 lbs of dry ice. Specimens must arrive in a frozen state.

Additional Information: Double-centrifuged specimen is critical for accurate results as platelet contamination may cause spurious results.

 

PT G20210A Gene Mutation, Factor V Leiden Mutation

Specimen Type: Whole blood
Container/Tube: Blue top (3.2% sodium citrate)

Specimen Volume: 1 Full tube

Collection Instructions: Send specimen in original tube.

Additional Information: If there is a delay in transport, send whole blood specimen refrigerated.

 

Homocysteine

Specimen Type: Heparinized or EDTA Plasma

Container/Tube: Green top (heparin) or lavender top (EDTA)

Specimen Volume: 1 Full tube

Collection Instructions:

1. Place tube immediately on  wet ice.

2. Send specimen in original tube.

Additional Information:

1. If there is a delay in transport, spin down, separate plasma from cells.

2. Transfer 0.5 mL of heparinized or EDTA plasma to a plastic vial.

3. Send plasma refrigerated.

Note: Specimens that cannot be separated soon after collection should be stored on wet ice until centrifugation. Homocysteine increases in plasma when separation from cells is delayed.

Specimen Rejection: Unfrozen specimen >48 hours old

 

Cardiolipin Antibodies: IgA, IgG, IgM, Beta-2 Glycoprotein 1 Antibodies: IgA, IgG, IgM

Specimen Type:  Serum

Container/Tube: Gold top

Specimen Volume: 2 mL

Collection Instructions: Draw specimen in a gold-top tube. Spin down and send refrigerated.

 

 

 

Quick Reference Guide

Primary Test

Components

Reflex Testing

#  of Tubes

Specimen Required

Homocysteine

Homocysteine

 

1

Heparinized or EDTA Plasma,

PLACE TUBE

 IMMEDIATELY

ON WET ICE.

Antithrombin III Activity

Antithrombin III Acitivity

Antithrombin Antigen

3

Blue, Citrated plasma,

double spun, frozen.

(3 Aliquots, frozen)

Protein C Antigen/

Factor VII Antigen Ratio

Protein C Antigen

Factor VII Antigen Ratio

 

Protein S Antigen/

Factor VII Antigen Ratio

Protein S Antigen

Factor VII Antigen Ratio

 

Factor VIII Assay

Factor VIII Assay

 

Lupus Inhibitor Screen (PTT)

DRVVT (Lupus-Like Anticoagulant)

DRVV Confirm

PTT

PTT Mixing Study

1

Blue, Citrated plasma

(must be run

within 4 hours)

Thrombin Time

PT/INR

PT/INR

 

Blue, Citrated plasma

(must be run

within 24 hours)

Factor V Leiden Mutation Analysis

Factor V Leiden Mutation

 

1

Blue, Citrated

WHOLE BLOOD,

ROOM TEMP

PT G20210A Gene Mutation

(Prothrombin Mutation)

PT G20210A Gene Mutation

(Prothrombin Mutation)

 

Antiphospholipid Profile

Cardiolipin IgA

 

1

Gold, Serum

Cardiolipin IgG

Cardiolipin IgM

Beta-2 Glycoprotein 1 IgA

 

Beta-2 Glycoprotein 1 IgG

Beta-2 Glycoprotein 1 IgM

 

Specimen Stability

Test

Specimen Type

Temperature

Time

Protime/INR

Whole Blood

Ambient

24 hours

Plasma Na Citrate

(double spun)

Frozen

14 days

Lupus Inhibitor Screen (PTT)

Antithrombin III Activity

Factor VIII Assay

DRVVT (Lupus-Like Anticoagulant)

Protein C Antigen/Factor VII Antigen Ratio

Protein S Antigen/Factor VII Antigen Ratio

Whole Blood

Ambient

4 hours

Plasma Na Citrate

(double spun)

Frozen

14 days

PT G20210A Gene Mutation

Factor V Leiden Mutation Analysis

Whole Blood

Ambient

24 hours

Refrigerated

14 days

Homocysteine

Plasma

Refrigerated

48 hours

Frozen

13 weeks

Beta-2 Glycoprotein 1 IgA, IgG, IgM

Cardiolipin IgA, IgG, IgM

Serum

Ambient

8 hours

Refrigerated

48 hours

Frozen

30 days

 

Reference Values

See individual test listings.

Day(s) Test Set Up

Thursday

Test Classification and CPT Coding

85300-Antithrombin III Activity

81240-PT G20210A Gene Mutation

81241-Factor V Leiden Mutation Analysis

85240-Factor VIII Assay

83090-Homocysteine

85612-DRVVT

85613-DRVVT diluted

85730-PTT(Lupus Inhibitor Screen)

86147x3-Cardiolipin Ab

86146x3-Beta-2 Glycoprotein 1 Ab

85303-Protein C Functional Activity

85306-Protein S Antigen, Free

85610-PT/INR

80500-Pathology Interp

 

Reflex Tests:

85301-Antithrombin Antigen

85302-Protein C Antigen

85305-Total Protein S

85613-DRVV Confirm

83520-C4 Binding Protein

85732-PTT Mixing Study

85670-Thrombin Time