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Thrombotic Risk Assessment

CPT 81240; 83090; 85300; 85303; 85306; 85307; 85420; 85613; 85732; 86146(x3); 86147(x3)

Test Details

Methodology

See individual tests.

Result Turnaround Time

3 - 7 days

Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.

Related Documents

For more information, please view the literature below.

Procedures for Hemostasis and Thrombosis: A Clinical Test Compendium

Test Includes

Activated protein C resistance (APCR) reflex to factor VLeiden mutation analysis; anticardiolipin antibodies (ACA), IgA, IgG, IgM; antithrombin activity; β2-glycoprotein 1 antibodies, IgA, IgG, IgM; factor II (prothrombin) DNA analysis; homocyst(e)ine, plasma; lupus anticoagulant with reflex; plasminogen activity; protein C, functional; protein S antigen, free

Specimen Requirements

Specimen

Plasma, frozen, and serum, refrigerated, and whole blood or buccal swab kit (buccal swab collection kit contains instructions for the use of a buccal swab)

Volume

2 mL frozen sodium citrate plasma and 1 mL serum and 7 mL whole blood or buccal swab

Container

Blue-top (sodium citrate) tube, gel-barrier tube, lavender-top (EDTA) tube, yellow-top (ACD) tube, or Labcorp buccal swab kit

Collection Instructions

Citrated plasma samples should be collected by double centrifugation. Blood should be collected in a blue-top tube containing 3.2% buffered sodium citrate.1 Evacuated collection tubes must be filled to completion to ensure a proper blood to anticoagulant ratio.2,3 The sample should be mixed immediately by gentle inversion at least six times to ensure adequate mixing of the anticoagulant with the blood. A discard tube is not required prior to collection of coagulation samples.4,5 When noncitrate tubes are collected for other tests, collect sterile and nonadditive (red-top) tubes prior to citrate (blue-top) tubes. Any tube containing an alternate anticoagulant should be collected after the blue-top tubes. Gel-barrier tubes and serum tubes with clot initiators should also be collected after the citrate tubes. Centrifuge for 10 minutes and (using a plastic transfer pipette) carefully remove two-thirds of the plasma without disturbing the cells. Deliver to a plastic transfer tube, cap, and recentrifuge for 10 minutes. Use a second plastic pipette to remove the plasma, staying clear of the platelets at the bottom of the tube. Transfer the plasma into a Labcorp PP transpak frozen purple tube with screw cap (Labcorp No. 23751). The specimen should be frozen immediately and maintained frozen until tested. To avoid delays in turnaround time when requesting multiple tests on frozen samples, please submit separate frozen specimens for each test requested.

Please print and use the Volume Guide for Coagulation Testing to ensure proper draw volume.

Storage Instructions

Freeze plasma. Refrigerate serum. Maintain whole blood and buccal swab kit at room temperature or refrigerate.

Patient Preparation

Do not draw from an arm with a heparin lock or heparinized catheter.

References

Alving BM. The antiphospholipid syndrome: Clinical presentation, diagnosis, and patient management. In: Kitchens CS, Alving BM, Kessler CM, eds Consultative Hemostasis and Thrombosis. Philadelphia, Pa: WB Saunders Co; 2002:181-196.
Schafer AI, Levine MN, Konkle BA, et al. Thrombotic disorders: Diagnosis and treatment. Hematology (Am Soc Hematol Educ Program). 2003; 520-539. 14633797
Triplett DA. Thrombophilia. In: McClatchey KD, ed. Clinical Laboratory Medicine. 2nd ed. Philadelphia, Pa: Lippincott Williams and Wilkins;2002:1033-1049.

Footnotes

1. Adcock DM, Kressin DC, Marlar RA. Effect of 3.2% vs 3.8% sodium citrate concentration on routine coagulation testing. Am J Clin Pathol. 1997; 107(1):105-110. 8980376
2. Reneke J, Etzell J, Leslie S, et al. Prolonged prothrombin time and activated partial thromboplastin time due to underfilled specimen tubes with 109 mmol/L (3.2%) citrate anticoagulant. Am J Clin Pathol. 1998; 109(6):754-757. 9620035
3. National Committee for Clinical Laboratory Standardization. Collection, Transport, and Processing of Blood Specimens for Coagulation Testing and General Performance of Coagulation Assays; Approved Guideline. 5th ed. Villanova, Pa: NCCLS; 2008. Document H21-A5:28(5).
4. Gottfried EL, Adachi MM. Prothrombin time and activated partial thromboplastin time can be performed on the first tube. Am J Clin Pathol. 1997; 107(6):681-683.9169665
5. McGlasson DL, More L, Best HA, et al. Drawing specimens for coagulation testing: Is a second tube necessary? Clin Lab Sci. 1999; 12(3):137-139. 10539100

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
117720 Thrombotic Risk Assessment 707009 Homocyst(e)ine umol/L 13965-9
117720 Thrombotic Risk Assessment 117714 Plasminogen % 5970-9
117720 Thrombotic Risk Assessment 015040 Antithrombin Activity % 27811-9
117720 Thrombotic Risk Assessment 117705 Protein C-Functional % 27819-2
117720 Thrombotic Risk Assessment 164519 Protein S, Free % 27821-8
117720 Thrombotic Risk Assessment 117763 Act.Prt.C Resist. ratio 13590-5
117720 Thrombotic Risk Assessment 117871 FVDNA TRACKING N/A
117720 Thrombotic Risk Assessment 117003 PTT-LA sec 34571-0
117720 Thrombotic Risk Assessment 117891 dRVVT sec 6303-2
117720 Thrombotic Risk Assessment 117893 Lupus Reflex Interpretation 75514-0
117720 Thrombotic Risk Assessment 161812 Anticardiolipin Ab,IgG,Qn GPL U/mL 3181-5
117720 Thrombotic Risk Assessment 161830 Anticardiolipin Ab,IgM,Qn MPL U/mL 3182-3
117720 Thrombotic Risk Assessment 161838 Anticardiolipin Ab,IgA,Qn APL U/mL 5076-5
117720 Thrombotic Risk Assessment 163881 Beta-2 Glycoprotein I Ab, IgG GPI IgG units 16135-6
117720 Thrombotic Risk Assessment 163899 Beta-2 Glycoprotein I Ab, IgA GPI IgA units 21108-6
117720 Thrombotic Risk Assessment 163907 Beta-2 Glycoprotein I Ab, IgM GPI IgM units 16136-4
117720 Thrombotic Risk Assessment 511218 Factor II, DNA Analysis 24476-4
117720 Thrombotic Risk Assessment 512253 Reviewed by: 56850-1
Order Code117720
Order Code NameThrombotic Risk Assessment
Order Loinc
Result Code707009
Result Code NameHomocyst(e)ine
UofMumol/L
Result LOINC13965-9
Order Code117720
Order Code NameThrombotic Risk Assessment
Order Loinc
Result Code117714
Result Code NamePlasminogen
UofM%
Result LOINC5970-9
Order Code117720
Order Code NameThrombotic Risk Assessment
Order Loinc
Result Code015040
Result Code NameAntithrombin Activity
UofM%
Result LOINC27811-9
Order Code117720
Order Code NameThrombotic Risk Assessment
Order Loinc
Result Code117705
Result Code NameProtein C-Functional
UofM%
Result LOINC27819-2
Order Code117720
Order Code NameThrombotic Risk Assessment
Order Loinc
Result Code164519
Result Code NameProtein S, Free
UofM%
Result LOINC27821-8
Order Code117720
Order Code NameThrombotic Risk Assessment
Order Loinc
Result Code117763
Result Code NameAct.Prt.C Resist.
UofMratio
Result LOINC13590-5
Order Code117720
Order Code NameThrombotic Risk Assessment
Order Loinc
Result Code117871
Result Code NameFVDNA TRACKING
UofM
Result LOINCN/A
Order Code117720
Order Code NameThrombotic Risk Assessment
Order Loinc
Result Code117003
Result Code NamePTT-LA
UofMsec
Result LOINC34571-0
Order Code117720
Order Code NameThrombotic Risk Assessment
Order Loinc
Result Code117891
Result Code NamedRVVT
UofMsec
Result LOINC6303-2
Order Code117720
Order Code NameThrombotic Risk Assessment
Order Loinc
Result Code117893
Result Code NameLupus Reflex Interpretation
UofM
Result LOINC75514-0
Order Code117720
Order Code NameThrombotic Risk Assessment
Order Loinc
Result Code161812
Result Code NameAnticardiolipin Ab,IgG,Qn
UofMGPL U/mL
Result LOINC3181-5
Order Code117720
Order Code NameThrombotic Risk Assessment
Order Loinc
Result Code161830
Result Code NameAnticardiolipin Ab,IgM,Qn
UofMMPL U/mL
Result LOINC3182-3
Order Code117720
Order Code NameThrombotic Risk Assessment
Order Loinc
Result Code161838
Result Code NameAnticardiolipin Ab,IgA,Qn
UofMAPL U/mL
Result LOINC5076-5
Order Code117720
Order Code NameThrombotic Risk Assessment
Order Loinc
Result Code163881
Result Code NameBeta-2 Glycoprotein I Ab, IgG
UofMGPI IgG units
Result LOINC16135-6
Order Code117720
Order Code NameThrombotic Risk Assessment
Order Loinc
Result Code163899
Result Code NameBeta-2 Glycoprotein I Ab, IgA
UofMGPI IgA units
Result LOINC21108-6
Order Code117720
Order Code NameThrombotic Risk Assessment
Order Loinc
Result Code163907
Result Code NameBeta-2 Glycoprotein I Ab, IgM
UofMGPI IgM units
Result LOINC16136-4
Order Code117720
Order Code NameThrombotic Risk Assessment
Order Loinc
Result Code511218
Result Code NameFactor II, DNA Analysis
UofM
Result LOINC24476-4
Order Code117720
Order Code NameThrombotic Risk Assessment
Order Loinc
Result Code512253
Result Code NameReviewed by:
UofM
Result LOINC56850-1
Reflex Table for Act.Prt.C Resist.
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 511260 Factor V Leiden Mutation 511262 Factor V Leiden 21667-1
Reflex 1
Order Code511260
Order NameFactor V Leiden Mutation
Result Code511262
Result NameFactor V Leiden
UofM
Result LOINC21667-1
Reflex Table for Act.Prt.C Resist.
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 511260 Factor V Leiden Mutation 512256 Reviewed by: Pending
Reflex 1
Order Code511260
Order NameFactor V Leiden Mutation
Result Code512256
Result NameReviewed by:
UofM
Result LOINCPending
Reflex Table for PTT-LA
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 117040 PTT-LA Mix 117005 PTT-LA Mix sec 75510-8
Reflex 1
Order Code117040
Order NamePTT-LA Mix
Result Code117005
Result NamePTT-LA Mix
UofMsec
Result LOINC75510-8
Reflex Table for PTT-LA
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 117040 PTT-LA Mix 117005 PTT-LA Mix sec 75510-8
Reflex 1
Order Code117040
Order NamePTT-LA Mix
Result Code117005
Result NamePTT-LA Mix
UofMsec
Result LOINC75510-8