|Print View Attached Docs:|
|25932:COAGULATION STUDY, THROMBOSIS EVALUATION, ADVERSE PREGNANCY OUTCOME|
|Alias Names:||Thrombosis Evaluation, Adverse Pregnancy Outcome|
|Methodology:||Polymerase Chain Reaction (PCR) / Enzyme-Linked Immunosorbent Assay (ELISA) / Mechanical Clot Detection|
|Components:||Activated Protein C Resistance / Anticardiolipin Antibodies, IgG and IgM / Beta-2 Glycoprotein Antibodies, IgG & IgM / Lupus Anticoagulant / Methylenetetrahydrofolate (MTHFR) Mutation / Protein C Activity / Prothrombin Gene Mutation|
|CPT Code:||83891-3G / 83896-3G x2 / 83898-3G / 83903-3G / 83912-3G / 85303 / 85307 / 85613 / 85730 / 86146 x2 / 86147 x2 / 83890-903F / 83896-903F x4 / 83900-903F / 83912-903F|
|Specimen Collection Details|
|Collection:||Total of seven tubes collected: Four 4.5 mL light blue top tubes (sodium citrate), and two 4 mL lavender top tubes (EDTA), and one 5 mL red top tube or 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. For STAT, refrigerate and keep capped in original tubes and 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 using a plastic pipette, transfer the top 2/3 of the plasma into 3-4 plastic vials. Freeze immediately. Label citrated plasma with patient name, I.D. number, test, and “citrate.” Serum from the red top tube can be centrifuged and transferred to a single tube, labeled with patient name, test, I.D. number, and “serum.” The EDTA tube must be submitted as refrigerated whole blood. Send to 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 two 4 mL lavender top tubes (whole blood) 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) and two 4 mL lavender top tubes (whole blood).|
|Transport:||Original tubes refrigerated if STAT; citrated plasma frozen on dry ice; whole blood and serum refrigerated.|
|Rejection Criteria:||Frozen whole blood; marked hemolysis; specimen received in laboratory beyond the stated stability.
This test may require insurance company prior authorization before ordering.
Please check the prior authorization list .
Failure to gain preauthorization may result in denial of coverage.