Geisinger Medical Laboratories Test Catalog
THROMBOSIS PROFILE |
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Geisinger Epic Procedure Code: LAB3154
Geisinger Epic ID: 26811
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SPECIMEN COLLECTION |
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Specimen type: |
Platelet-poor plasma AND serum. | |
Preferred collection container: |
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Alternate Collection Container: |
Other size blue-top (3.2% sodium citrate) tubes (e.g., 1.8 mL, 4.5 mL)
6 mL red-top (plain, non-serum separator) tube
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Specimen required: |
Eight (8) 1 mL plasma aliquots AND (1) 0.5 mL serum Collect four (4) 2.7 mL blue-top tubes (3.2% sodium citrate) AND one (1) 3.5 mL gold-top (serum separator) tube. |
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Special notes: |
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Patient preparation: |
Thrombosis testing immediately after a thrombotic event is discouraged. Patient should be off all anticoagulation prior to collection as follows: Heparin- 48 hours Coumadin - 2 weeks Direct thrombin or Xa inhibitors - 7 days Anti-platelet medication- no need to stop |
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SPECIMEN PROCESSING |
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Specimen processing instructions: |
Centrifuge blue top specimens immediately at designated time and speed to obtain platelet-poor plasma (<10,000/µL). Using a plastic pipette, carefully remove plasma from cells, avoiding platelet/buffy layer by leaving a thin layer of plasma on top the cells. The centrifuged plasma should be aliquoted (1 mL per aliquot) into clearly labeled polypropylene tubes. Eight (8) plasma aliquots needed. Check the residual specimen for clot and if present discard sample and redraw specimen. Freeze upright and transport on dry ice.
Allow serum to clot. Centrifuge and submit 0.5 mL serum. |
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Transport temperature: |
Eight (8) aliquots of citrated plasma frozen, one (1) aliquot of serum refrigerated | |
Specimen stability: |
Plasma room temperature: 4 hours Plasma frozen -20°C: 2 weeks Plasma frozen -70°C: 6 months Serum room temperature: 8 hours Serum refrigerated 2-8°C: 48 hours Serum frozen: 6 months |
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Rejection criteria: |
Clotted, hemolyzed, icteric (test specific), lipemic (test specific) improperly filled tubes, improper anticoagulant ratio (HCT >55% and citrate not adjusted), refrigerated specimens, or stability exceeded.
Note: Specimen suspected of thawing in transport, indicated by slant in aliquot or specimen in lid of tube, will have testing performed, and the comment “interpret results with caution as thawing suspected” added to results. |
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TEST DETAILS |
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Reference interval: |
See individual tests. | |
CPT code(s): |
85613, 85730, 86147 x2, 86146 x2, 85300, 85306, 85384, 85303, If reflex testing needed the following may be added depending on lupus profile algorithm and protein S activity reflex panel: 85613 x2, 85730, 85525 x7, 85610, 85597, 85670 x2, 85520, 85384, 88732, 85597, 85306, 85305 | |
Note: The billing party has sole responsibility for CPT coding. Any questions regarding coding should be directed to the payer being billed. The CPT codes provided by GML are based on AMA guidelines and are for informational purposes only. | ||
Test includes: |
Antithrombin III Activity, Protein C Activity, Protein S Activity with reflex to Free and Total Protein S Antigen, Lupus Sensitive APTT with reflex heparin neutralization, Mixing, and platelet neutralization confirmation; DRVVT with reflexive heparin neutralization, Mixing, and Confirmation; IgG and IgM Anticardiolipin antibodies, IgG and IgM Beta-2-Glycoprotein antibodies, if required by algorithm fibrinogen, Heparin Unfractionated and/or Thrombin Time with and without heparin neutralization if indicated.
Profile does NOT include Factor V (5) Leiden or Prothrombin gene mutation testing. |
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Methodology: |
Mechanical clot-based Enzyme Immunoassay (EIA) Chromogenic |
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Synonyms: |
THRMP, Hypercoagulation panel Hypercoagulability Thrombophilic, thrombotic, lupus anticoagulant
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Clinical significance: |
Thrombosis profile evaluates for inherited and acquired thrombophilia risk factors in patients with a clotting event and/or a strong family history of unprovoked blood clot. Results should be combined with clinical history and clinical risk factors to determine the need for extended anticoagulation. Thrombotic testing immediately after a thrombotic event is discourage. Anticoagulant therapy and ongoing or recent thrombotic events interfere with interpreation of some results, especially lupus anticoagulant profile testing. If anticoagulation is detected the lupus profile will be resulted with a comment stating anticoagulation detect and indeterminant for lupus anticoagulant. See Anticoagulation Impact on Coagulation Tests for effects on other analytes. | |
Doctoral Director(s:) |
Michelle Grant DO | |
Review Date: | 03/31/2023 |