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Test Code BLOD1448 Thrombotic Risk Panel with Reflex

Important Note

Special Handling Required.  Please draw the following:

  • 5 blue
  • 1 gold

Specimen must arrive and be tested within 4 hours of draw.  See Specimen Requirements below for further instructions.

Patient should not be receiving Coumadin or heparin. If so, this should be noted as the test profile will be different. Heparin or warfarin therapy can affect certain coagulation factor assays, preclude their performance, or cause spurious results.  Refer to:

Useful For

  • Evaluating patients with thrombosis or hypercoagulability states
  • Detecting a lupus-like anticoagulant
  • Detecting a deficiency of antithrombin, protein C, or free protein S
  • Detecting a prothrombin G20210A mutation
  • Detecting a Factor V Leiden Mutation

Profile Information

 

Test Code

Test 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

BLOD0670

DRVVT

(Lupus-Like Anticoagulant)

Photometric

Yes

Yes

LABS0236

Lupus Inhibitor Screen (PTT)

Photometric

No

Yes

BLOD0298

Cardiolipin IgG Antibody

ELISA

Yes

Yes

BLOD0299

Cardiolipin IgM Antibody

ELISA

Yes

Yes

BLOD1332

Beta-2 Gylcoprotein 1 IgG Ab

ELISA

Yes

Yes

BLOD1333

Beta-2 Gylcoprotein 1 IgM Ab

ELISA

Yes

Yes

BLOD0224

Protein C Functional Activity

Chromogenic

Yes

Yes

BLOD0225

Protein S Antigen

Chromogenic

Yes

Yes

BLOD0669

Protime/INR

Photo-Optical

Yes

Yes

PATH1014

Pathologist Interpretation

Manual

No

Yes

 

Reflex Tests

 

Test Code

Test Name

Performing Laboratory

Available Separately

Always Performed

BLOD0222

Antithrombin Antigen

Mayo Medical Laboratories

Yes

No

BLOD0223

Protein C Antigen

Mayo Medical Laboratories

Yes

No

LABS0620

Total Protein S

Esoterix

Yes

No

LABS0126

DRVV Confirm

Bozeman Health Laboratory Services

No

No

BLOD1451

C4 Binding Protein

Esoterix

Yes

No

LABS0212

APTT 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 protein C activity is decreased, then protein C antigen will be performed at an additional charge.
If free protein S antigen is decreased, then a total protein S antigen and C4b binding protein 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

Specimens 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.

 

Phospholipid (Cardiolipin) Antibodies: IgG, IgM, Beta-2 Glycoprotein 1 Antibodies 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

Antithrombin III Activity

Antithrombin III Acitivity

Antithrombin Antigen

3

Blue, Citrated plasma,

double spun, frozen.

(3 frozen aliquots)

Protein C Functional Activity

Protein C Functional Activity

Protein C Antigen

Protein S Antigen

Protein S Antigen

Total Protein S

C4b Binding Protein

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 IgG

 

1

Gold, Serum

Cardiolipin IgM

Beta-2 Glycoprotein 1 IgG

 

Beta-2 Glycoprotein 1 IgM

 

Specimen Transport Temperature

  ReRefeAmbient <4 hrs

 

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 Functional Activity

Protein S Antigen

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

Beta-2 Glycoprotein 1 IgG, IgM

Cardiolipin 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

85612-DRVVT

85613-DRVVT diluted

85730-PTT(Lupus Inhibitor Screen)

86147x2-Cardiolipin Ab

86146x2 Beta-2 Glycoprotein Ab

85303-Protein C Functional Activity

85306-Protein S Antigen, Free

85610-PT/INR

85390-Coagulation Review

80500-Pathology Interp/Mixing Studies

 

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