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Coagulation Screening Reflexive Evaluation

Test Number 505421
Test number copied
CPT 80503; 85598; 85610; 85613(x2); 85670; 85730

Test Details

Methodology

Clot detection, nephelometry, ELISA

Result Turnaround Time

3 - 10 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.

Test Includes

Prothrombin Time (PT); International Normalized Ratio (INR); Activated Partial Thromboplastin Time (aPTT); Thrombin Time (TT); Dilute Russell’s Viper Venom Time (dRVVT); Hexagonal Phospholipid Neutralization (HEX); Pathologist Interpretation

Use

Screening to support and direct the diagnosis of coagulation disorders

Special Instructions

The following reflex tests may be performed per profile specifications and/or pathologist discretion: Factor II Activity; Factor V Activity; Factor VII Activity; Factor X Activity; Factor VIII Activity, Factor IX Activity, Factor XI Activity; Prothrombin Time Mixing Studies; Activated Partial Thromboplastin Time Mixing Studies; Thrombin Time following Heparin Neutralization; Fibrinogen Activity; Fibrinogen Antigen; Reptilase; Anticardiolipin Antibody IgG and IgM; β2 Glycoprotein I IgG and IgM; Factor XII Activity; Prekallikrein (Fletcher Factor) Assay; High Molecular Weight Kininogen (Fitzgerald Factor)

If reflex testing is performed, concomitant CPT codes/charges will apply.

Depending on base assay results, the following reflex testing may be performed:

• If PT is above normal reference interval, Factor Activities II, V, VII and X shall be performed.

• If PT is more than 2 seconds above normal reference interval, Factor Activities II, V, VII and X and PT Mixing Studies shall be performed.

• If aPTT is above normal reference interval and results do not suggest heparin interference, Factor Activities VIII, IX and XI shall be performed.

• If aPTT is more than 3 seconds above normal reference interval and results do not suggest heparin interference, Factor Activities VIII, IX and XI and aPTT Mixing Studies shall be performed.

• If TT is above normal reference interval and results do not suggest heparin interference, Fibrinogen Activity, Fibrinogen Antigen and Reptilase shall be performed.

• If TT is above normal reference interval and results suggest possible heparin interference, TT shall be repeated following heparin neutralization.

• If dRVVT and/or Hex is above normal reference interval, Anticardiolipin Antibody IgG and IgM, and β2 Glycoprotein I IgG and IgM shall be performed.

Depending on base assay results and primary reflex test results, the following secondary reflex testing may be performed:

• If TT is repeated following heparin neutralization and heparin interference is ruled out, Fibrinogen Activity, Fibrinogen Antigen and Reptilase shall be performed.

• If aPTT is above normal reference interval, results do not suggest the presence of a Lupus Anticoagulant and no factor activity below normal reference interval has been identified, Factor XII Activity, Prekallikrein Assay and High Molecular Weight Kininogen shall be performed.

Specimen Requirements

Specimen

Citrated plasma, frozen; and serum, frozen

Volume

Three transport tubes, each containing 2.0 mL plasma, and one transport tube containing 2.0 mL serum

Container

Light blue-top (sodium citrate) collection tubes; red-top (no additive) collection tube

Collection Instructions

Plasma/serum must be separated from cells within 45 minutes of venipuncture, and centrifuged a second time before being placed in plastic transport tubes. Freeze plasma/serum within two hours and keep frozen until testing is performed.

Storage Instructions

Freeze.

Patient Preparation

Ideally, the patient should not be on anticoagulant therapy. Avoid warfarin (Coumadin®) therapy for two weeks prior to testing. Avoid heparin, direct Xa and thrombin inhibitor therapies for three days prior to testing.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
505421 COAG Screen Reflexive Eval 98125-8 500372 Prothrombin Time sec 5902-2
505421 COAG Screen Reflexive Eval 98125-8 500682 INR ratio 6301-6
505421 COAG Screen Reflexive Eval 98125-8 500513 APTT sec 14979-9
505421 COAG Screen Reflexive Eval 98125-8 500230 Thrombin Time sec 3243-3
505421 COAG Screen Reflexive Eval 98125-8 501549 DRVVT Screen Seconds sec 6303-2
505421 COAG Screen Reflexive Eval 98125-8 501548 DRVVT Confirm Seconds sec 57838-5
505421 COAG Screen Reflexive Eval 98125-8 500585 DRVVT Ratio ratio 50410-0
505421 COAG Screen Reflexive Eval 98125-8 500569 Hexagonal Phospholipid Neutral sec 3282-1
505421 COAG Screen Reflexive Eval 98125-8 500684 Pathologist Interpretation 21026-0
505421 COAG Screen Reflexive Eval 98125-8 505804 Reflex Added N/A
Order Code505421
Order Code NameCOAG Screen Reflexive Eval
Order Loinc98125-8
Result Code500372
Result Code NameProthrombin Time
UofMsec
Result LOINC5902-2
Order Code505421
Order Code NameCOAG Screen Reflexive Eval
Order Loinc98125-8
Result Code500682
Result Code NameINR
UofMratio
Result LOINC6301-6
Order Code505421
Order Code NameCOAG Screen Reflexive Eval
Order Loinc98125-8
Result Code500513
Result Code NameAPTT
UofMsec
Result LOINC14979-9
Order Code505421
Order Code NameCOAG Screen Reflexive Eval
Order Loinc98125-8
Result Code500230
Result Code NameThrombin Time
UofMsec
Result LOINC3243-3
Order Code505421
Order Code NameCOAG Screen Reflexive Eval
Order Loinc98125-8
Result Code501549
Result Code NameDRVVT Screen Seconds
UofMsec
Result LOINC6303-2
Order Code505421
Order Code NameCOAG Screen Reflexive Eval
Order Loinc98125-8
Result Code501548
Result Code NameDRVVT Confirm Seconds
UofMsec
Result LOINC57838-5
Order Code505421
Order Code NameCOAG Screen Reflexive Eval
Order Loinc98125-8
Result Code500585
Result Code NameDRVVT Ratio
UofMratio
Result LOINC50410-0
Order Code505421
Order Code NameCOAG Screen Reflexive Eval
Order Loinc98125-8
Result Code500569
Result Code NameHexagonal Phospholipid Neutral
UofMsec
Result LOINC3282-1
Order Code505421
Order Code NameCOAG Screen Reflexive Eval
Order Loinc98125-8
Result Code500684
Result Code NamePathologist Interpretation
UofM
Result LOINC21026-0
Order Code505421
Order Code NameCOAG Screen Reflexive Eval
Order Loinc98125-8
Result Code505804
Result Code NameReflex Added
UofM
Result LOINCN/A
Reflex Table for Thrombin Time
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 500233 Thrombin Time-Heparin Neutral. 500233 Thrombin Time-Heparin Neutral. sec 46224-2
Reflex 1
Order Code500233
Order NameThrombin Time-Heparin Neutral.
Result Code500233
Result NameThrombin Time-Heparin Neutral.
UofMsec
Result LOINC46224-2
Reflex Table for Reflex Added
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 505551 PT 1:1 NP Panel 500373 PT 1:1 NP sec 5959-2
Reflex 1
Order Code505551
Order NamePT 1:1 NP Panel
Result Code500373
Result NamePT 1:1 NP
UofMsec
Result LOINC5959-2
Reflex Table for Reflex Added
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 505551 PT 1:1 NP Panel 500375 PT 1:1 NP 60 Inc sec 33356-7
Reflex 1
Order Code505551
Order NamePT 1:1 NP Panel
Result Code500375
Result NamePT 1:1 NP 60 Inc
UofMsec
Result LOINC33356-7
Reflex Table for Reflex Added
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 505551 PT 1:1 NP Panel 500376 PT 1:1 NP 60 Min Inc. control sec 33884-8
Reflex 1
Order Code505551
Order NamePT 1:1 NP Panel
Result Code500376
Result NamePT 1:1 NP 60 Min Inc. control
UofMsec
Result LOINC33884-8
Reflex Table for Reflex Added
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 505552 APTT 1:1 Panel 500363 APTT 1:1 NP sec 5946-9
Reflex 1
Order Code505552
Order NameAPTT 1:1 Panel
Result Code500363
Result NameAPTT 1:1 NP
UofMsec
Result LOINC5946-9
Reflex Table for Reflex Added
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 505552 APTT 1:1 Panel 500364 APTT 1:1 Saline Sec 43734-3
Reflex 1
Order Code505552
Order NameAPTT 1:1 Panel
Result Code500364
Result NameAPTT 1:1 Saline
UofMSec
Result LOINC43734-3
Reflex Table for Reflex Added
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 505552 APTT 1:1 Panel 500657 APTT 1:1 NP, 60 min Incubation sec 30323-0
Reflex 1
Order Code505552
Order NameAPTT 1:1 Panel
Result Code500657
Result NameAPTT 1:1 NP, 60 min Incubation
UofMsec
Result LOINC30323-0
Reflex Table for Reflex Added
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 505553 Factor Activity Panel 500501 Factor II Activity % 3289-6
Reflex 1
Order Code505553
Order NameFactor Activity Panel
Result Code500501
Result NameFactor II Activity
UofM%
Result LOINC3289-6
Reflex Table for Reflex Added
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 505553 Factor Activity Panel 500676 Factor V Activity % 3193-0
Reflex 1
Order Code505553
Order NameFactor Activity Panel
Result Code500676
Result NameFactor V Activity
UofM%
Result LOINC3193-0
Reflex Table for Reflex Added
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 505553 Factor Activity Panel 500679 Factor VII Activity % 3198-9
Reflex 1
Order Code505553
Order NameFactor Activity Panel
Result Code500679
Result NameFactor VII Activity
UofM%
Result LOINC3198-9
Reflex Table for Reflex Added
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 505553 Factor Activity Panel 500666 Factor VIII Activity % 3209-4
Reflex 1
Order Code505553
Order NameFactor Activity Panel
Result Code500666
Result NameFactor VIII Activity
UofM%
Result LOINC3209-4
Reflex Table for Reflex Added
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 505553 Factor Activity Panel 500672 Factor IX Activity % 3187-2
Reflex 1
Order Code505553
Order NameFactor Activity Panel
Result Code500672
Result NameFactor IX Activity
UofM%
Result LOINC3187-2
Reflex Table for Reflex Added
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 505553 Factor Activity Panel 500688 Factor X Activity % 3218-5
Reflex 1
Order Code505553
Order NameFactor Activity Panel
Result Code500688
Result NameFactor X Activity
UofM%
Result LOINC3218-5
Reflex Table for Reflex Added
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 505553 Factor Activity Panel 500674 Factor XI Activity % 3226-8
Reflex 1
Order Code505553
Order NameFactor Activity Panel
Result Code500674
Result NameFactor XI Activity
UofM%
Result LOINC3226-8
Reflex Table for Reflex Added
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 505553 Factor Activity Panel 500367 Factor XII Activity % 3232-6
Reflex 1
Order Code505553
Order NameFactor Activity Panel
Result Code500367
Result NameFactor XII Activity
UofM%
Result LOINC3232-6
Reflex Table for Reflex Added
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 502451 Fibrinogen Activity+Antigen 500701 Fibrinogen Activity mg/dL 3255-7
Reflex 1
Order Code502451
Order NameFibrinogen Activity+Antigen
Result Code500701
Result NameFibrinogen Activity
UofMmg/dL
Result LOINC3255-7
Reflex Table for Reflex Added
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 502451 Fibrinogen Activity+Antigen 500702 Fibrinogen Antigen mg/dL 42772-4
Reflex 1
Order Code502451
Order NameFibrinogen Activity+Antigen
Result Code500702
Result NameFibrinogen Antigen
UofMmg/dL
Result LOINC42772-4
Reflex Table for Reflex Added
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 501721 Anticardiolipin IgG/M 500571 Anticardiolipin Ab, IgM MPL 3182-3
Reflex 1
Order Code501721
Order NameAnticardiolipin IgG/M
Result Code500571
Result NameAnticardiolipin Ab, IgM
UofMMPL
Result LOINC3182-3
Reflex Table for Reflex Added
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 501721 Anticardiolipin IgG/M 500575 Anticardiolipin Ab, IgG GPL 3181-5
Reflex 1
Order Code501721
Order NameAnticardiolipin IgG/M
Result Code500575
Result NameAnticardiolipin Ab, IgG
UofMGPL
Result LOINC3181-5
Reflex Table for Reflex Added
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 500589 Beta-2 Glycoprotein I, IgG 500589 Beta-2 Glycoprotein I, IgG SGU 16135-6
Reflex 1
Order Code500589
Order NameBeta-2 Glycoprotein I, IgG
Result Code500589
Result NameBeta-2 Glycoprotein I, IgG
UofMSGU
Result LOINC16135-6
Reflex Table for Reflex Added
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 500593 Beta-2 Glycoprotein I, IgM 500593 Beta-2 Glycoprotein I, IgM SMU 16136-4
Reflex 1
Order Code500593
Order NameBeta-2 Glycoprotein I, IgM
Result Code500593
Result NameBeta-2 Glycoprotein I, IgM
UofMSMU
Result LOINC16136-4
Reflex Table for Reflex Added
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 500195 Prekallikrein Assay 500195 Prekallikrein Assay % 52759-8
Reflex 1
Order Code500195
Order NamePrekallikrein Assay
Result Code500195
Result NamePrekallikrein Assay
UofM%
Result LOINC52759-8
Reflex Table for Reflex Added
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 500461 Kininogen Activity 500461 Kininogen Activity % 52754-9
Reflex 1
Order Code500461
Order NameKininogen Activity
Result Code500461
Result NameKininogen Activity
UofM%
Result LOINC52754-9
Reflex Table for Reflex Added
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 500449 Reptilase Time 500449 Reptilase Time sec 6683-7
Reflex 1
Order Code500449
Order NameReptilase Time
Result Code500449
Result NameReptilase Time
UofMsec
Result LOINC6683-7