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Specimen Collection Manual and Test Catalog

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FACTOR V (5) CLOTTING ACTIVITY (NOT LEIDEN)

Geisinger Epic Procedure Code:  LAB2254    Geisinger Epic ID:  7121
Test Restriction:  ORDER LIMITED TO HEMATOLOGY ONCOLOGY

SPECIMEN COLLECTION
Specimen type: 

Platelet-poor plasma


Preferred collection container: 
Alternate collection container: 
Other size blue-top (3.2% sodium citrate) tubes (e.g., 1.8 mL, 4.5 mL)
Specimen required: 

1 mL plasma aliquot for a single factor study. Each additional factor study requires an additional 0.5 mL aliquot. Samples requiring heparin neutralization require an additional 0.5 mL for each factor.


Special notes: 
  • If the patient’s hematocrit (HCT) is >55%, the volume of anticoagulant in the tube must be adjusted. Contact a performing location for sodium citrate adjusted tubes or instruction for how to adjust the sodium citrate.
  • When possible, use fresh venipuncture.
  • Avoid prolong tourniquet time (< 1 minute) and hemolysis during collection as this will alter results.
  • If indwelling catheter or butterfly collection device must be used, draw sample from a non-heparinized lumen or flush the line with 5 mL of saline and discard the first 10 mL of blood.
  • Tubes should be >90% filled.
  • Immediately mix gently after collection by inverting the tube end over end 5 to 6 times. Avoid vigorous mixing or additional inversion. Observe for the presence of clots or hemolysis and recollect if observed.


SPECIMEN PROCESSING
Processing instructions: 

Centrifuge as soon as possible (within 60 minutes) at designated speed and time to obtain platelet-poor plasma (< 10,000/uL). Remove plasma and re-spin the plasma for 10 minutes at 3000 rpm and submit platelet free plasma.

For a single NaCit blue top tube collection, create 1 aliquot NaCit and if additional plasma remains, create an additional aliquot NaCit. If multiple tubes collected, create 1 aliquot NaCit for each NaCIt blue top tube collected plus one additional aliquot NaCit. Aliquots should be 1.0-1.9 mL and all plasma-based coagulation tests must be moved to aliquot(s).


Transport temperature: 

Frozen on dry ice


Specimen stability: 

Room temperature (whole blood): 4 hours 
Room temperature (plasma off cells): 8 hours 
Frozen (plasma) -20°C: 2 weeks 
Frozen (plasma) -70°C: 6 months 


Rejection criteria: 

Clotted, hemolyzed, 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.



TEST DETAILS
Reference interval: 

50-150%


CPT code(s):  85220
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: 

Factor V activity


Methodology: 
Mechanical clot-based
Synonyms: 

Factor 5, FA5


Clinical significance: 

Factor V is a glycoprotein found in the common pathway of the clotting cascade. Low levels can result in a bleeding disorder. Factor V levels are decreased in patients with congenital deficiencies (rare), acquired factor 5 antibodies (rare), liver disease, and DIC. Factor V activity assay should be considered if PT and aPTT are both prolonged. This assay should not be used to assess the patient’s risk of thrombosis. 
Factor V Leiden Mutation (FVLM) is a different test for patients with a personal history of a blood clot. Pathology will investigate all orders for a Factor V assay to determine correct order practice.


Doctoral Director(s): 
Michelle Grant DO
Review Date:  09/03/2026

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