Activated Partial Thromboplastin Time (APTT) / Russell Viper Venom Time (RVVT) / Beta-2 Glycoprotein Antibodies, IgG and IgM / Cardiolipin Antibodies, IgG and IgM. Additional tests are added as needed, including: Activated Partial Thromboplastin Time (APTT) Mixing Study / Heparin Neutralized APTT / Hexagonal Lipid Neutralization / Thrombin Time / Russell Viper Venom Time Neutralization.
Performed:
Monday and Thursday with interpretation and reporting next day.
Released:
7 days
CPT Code:
85613 / 85730 / 86146 x2 / 86147 x2
Specimen Collection Details
Collection:
Total of five tubes 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). Collect by careful venipuncture to avoid tissue fluid contamination or hemolysis. Do not use needles smaller than 23 gauge. Fill blue tubes to maximum draw, at least 90% full. Mix by gentle inversion. Call the Special Coagulation Department (541.687.2134 x4612) when urgent testing is needed in order to assure STAT testing.
Handling:
Due to short stability, specimens must either be sent STAT to arrive at the laboratory within 4 hours, or sent frozen. Refrigerate and keep capped in original tubes if specimen will be received in laboratory within 4 hours. For STAT, refrigerate 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) and transfer using a plastic pipette, the top 2/3 of the plasma into 3-4 plastic vials. Label each tube with patient name, I.D. number, test, and “citrated plasma.” Freeze immediately. Centrifuge the red top tube and transfer serum into two tubes, each labeled with patient name, test, and “serum.” Refrigerate and send STAT, or freeze and send to the laboratory within 7 days. If multiple tests are ordered, freeze a separate aliquot for this test.
Standard Volume:
Four 4.5 mL light blue top tubes (or 4 mL 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 plasma).
Transport:
Original tubes refrigerated if sent STAT; or plasma or serum frozen on dry ice.
Comments:
Patients on high dose heparin (>1.0 U/mL) cannot be tested reliably for the lupus anticoagulant. It is advised in these patients to postpone testing until heparin has been discontinued at least 8 hours. 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 per cumm. If not, centrifuge speed and/or spin time should be increased. See also: Coagulation Study, Prolonged APTT Panel (25670) and Coagulation Study, Lupus Inhibitor Panel (25610).
Rejection Criteria:
Visible fibrin; moderate to marked hemolysis; specimens received in laboratory beyond the stated stability.
MEDICARE MAY REQUIRE A SIGNED ADVANCE BENEFICIARY NOTICE (ABN) FOR THIS TEST
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