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|25912:COAGULATION STUDY, THROMBOSIS EVALUATION, ARTERIAL|
|Methodology:||Enzyme-Linked Immunoassay (ELISA) / Chemiluminescence (CL)/ Mechanical Clot Detection|
|Components:||Anticardiolipin Antibodies, IgG and IgM / Beta-2 Glycoprotein IgG and IgM Antibodies / Lupus Anticoagulant / Protein C / Homocysteine|
|CPT Code:||83090 / 85613 / 85730 / 86146 x2 / 86147 x2|
|Specimen Collection Details|
|Collection:||Total of six tubes (venous blood) collected: Four 4.5 mL light blue top tubes (sodium citrate), AND one 5 mL red top tube OR one 7.5 mL serum separator tube (SST), AND one 4 mL lavender top tube (EDTA). Mix all tubes well by gentle inversion and place the lavender tube on ice immediately. Collect by careful venipuncture to avoid tissue fluid contamination or hemolysis. Do not use needles smaller than 23 guage. Fill blue tubes to maximum draw, at least 90% full.|
|Handling:||Due to short stability, specimens must either be sent STAT to arrive in laboratory within 4 hours, or sent frozen. Centrifuge EDTA tube and separate plasma for homocysteine testing within 1 hour of collection. Label aliquot “EDTA plasma,” and freeze. For STAT, refrigerate blue top tubes and keep capped in original tubes. Call for STAT pick-up. For standard delivery, centrifuge blue tubes to produce platelet-poor plasma (at least 1700 X g for 15 minutes to produce PLT CT less than 10,000 per cumm) and with a plastic pipette, transfer the top 2/3 of plasma into 3-4 plastic vials. Label citrated plasma with patient name, I.D. number, test, and “citrated plasma.” Freeze immediately. Send to laboratory within 7 days. If multiple tests are ordered, freeze a separate aliquot for this test.
NOTE: It is very important that plasma be “platelet-poor” prior to freezing to prevent neutralization of the lupus inhibitor by platelet phospholipids. Platelet counts on platelet-poor plasma should be consistently below 10,000/cumm. If not, centrifuge speed and/or increase spin time. Since cells continue to produce and release homocysteine, plasma must be off the cells within one hour of collection.
Centrifuge serum from the red top tube and transfer to a single tube, label with patient name, I.D. number, test, and “Anticardiolipin Ab – Serum.” Refrigerate if sent STAT, or freeze.
|Standard Volume:||Four 4.5 mL light blue top tubes (or 4 mL citrated plasma), AND one 4 mL lavender top tube (or 1 mL EDTA plasma), AND one 5 mL red top tube (or 1 mL serum).|
|Minimum Volume:||Two 2.7 mL light blue top tubes (or 2 mL citrated plasma), AND one 2 mL lavender top tube (or 0.5 mL EDTA plasma).|
|Transport:||EDTA plasma for homocysteine frozen on dry ice; other specimens in original tubes refrigerated if sent STAT; or plasma and serum frozen on dry ice.|
|Rejection Criteria:||Visible fibrin in plasma; moderate or marked hemolysis; specimen received beyond the stated stability.|