Geisinger Medical Laboratories/Geisinger Proven Diagnostics Test Catalog

Order Display Name: Geisinger Epic Procedure Code Or ID CPT Code:  

THROMBOSIS PROFILE

ORDERING INFORMATION:
Geisinger Epic Procedure Code: LAB3154         Geisinger Epic ID: 26811

SPECIMEN COLLECTION
Specimen type:
Platelet-poor plasma AND serum.
Preferred collection container:
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
Specimen required:
Eight (8) 1 mL aliquots of platelet-free citrated plasma AND (1) 1 mL aliquot of serum.
Special notes:
Collect four (4) 2.7 mL blue-top tubes (3.2% sodium citrate) AND one (1) 3.5 mL gold-top (serum separator) tube.

Perform venipuncture with no trauma. If blood is drawn from an indwelling catheter, flush with 5 mL of saline and discard the first 5 mL of blood collected to avoid contaminating sample with tissue thromboplastin or heparin. If blood is drawn with a butterfly device, draw a discard tube first to remove air from tubing.

Patient preparation:
Ideally patient should NOT be tested within 6 weeks of an acute thrombotic event or while on anticoagulation. Stop heparin 48 hours prior to testing, Coumadin 2 weeks prior to testing, direct thrombin inhibitors 7 days prior to testing, and direct Xa inhibitors 7 days prior to testing. If anticoagulation detected during testing some tests may not be performed.

SPECIMEN PROCESSING
Specimen processing instructions:
Centrifuge clotted gold-top tube top for 15 minutes at 2500 x g and blue-top tubes at the designated speed and time to obtain platelet-poor plasma (< 10,000/uL). Remove plasma and re-spin the plasma for 10 minutes at 2500 x g. Remove the supernatant platelet-free plasma into eight (8) 1 mL aliquots, freeze and transport frozen. 
Transport temperature:
Eight (8) aliquots of citrated plasma frozen, one (1) aliquot of serum refrigerated.
Specimen stability:
Frozen: -20°C for 30 days, -70°C for 6 months.
Rejection criteria:
Clotted, improperly filled or stability limits exceeded. HCT > 55 requires rejection, reorder in Beaker, and recollection with proper adjustment of anticoagulant.

Hemolyzed samples will receive the following comment: “Hemolysis detected which can cause false results, interpret with caution. Consider recollecting sample.”

Icteric and lipemic specimens may be rejected or testing may be limited depending on analyte.


TEST DETAILS
Reference interval:
See individual test members.
CPT code(s):
85610, 85730, 85613, 86147 x3, 85306, 85303, 85300, 85384
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:
PT INR, Fibrinogen, Antithrombin III, Lupus Sensitive aPTT Screen, Dilute Russell Viper Venom Time (DRVVT) Screen, Protein C Activity, Protein S Activity with Antigen Reflex, Cardiolipin Antibodies IgG/IgM and Beta-2 glycoprotein Antibody IgG/IgM. If needed Lupus Sensitive aPTT and DRVVT Mixing studies, Unfractionated Heparin, Thrombin Time, Heparin Neutralization, Platelet Neutralization and Dilute Russell Viper Venom Time Confirmation.
Methodology:
Mechanical Clot-Based
Enzyme-Linked Immunosorbent Assay (ELISA)
Chromogenic
Synonyms:
THRMP, Hypercoagulation panel
Hypercoagulability panel
Thrombophilic panel, thrombotic
Clinical significance:
Thrombosis profile evaluates for inherited and acquired thrombophilia risk factors in patients with unprovoked venous thromboembolism (VTE) and/or a strong family history of unprovoked VTE. Results should be used with clinical history and clinical risk factors to determine need for extended anticoagulation. Profile does NOT include Factor V (5) Leiden or Prothrombin gene mutation testing.
Doctoral Director(s:)
Michelle Grant DO    
Review Date: 01/06/2022

Performing Locations

Geisinger Medical Center

Performing laboratory: Coagulation
Technical Lead: Margaret Knowles-Tuchman
Frequency: First shift, twice weekly
Performed STAT? No
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