|Print View Attached Docs:|
|25911:COAGULATION STUDY, THROMBOSIS EVALUATION, VENOUS|
|Alias Names:||Thrombosis Eval, Comprehensive|
|Methodology:||Polymerase Chain Reaction (PCR) / Enzyme-Linked Immunosorbent Assay (ELISA) / Mechanical Clot Detection|
|Components:||Activated Protein C Assay / Antithrombin (ATIII) / Anticardiolipin Antibodies (IgG and IgM) / Beta-2 Glycoprotein Antibodies, IgG & IgM / Lupus Anticoagulant / Protein C Activity / Protein S Activity / Prothrombin Gene Mutation.|
|CPT Code:||83891-3G / 83896-3G x2 / 83898-3G / 83903-3G / 83912-3G / 85300 / 85303 / 85306 / 85307 / 85613 / 85730 / 86146 x2 / 86147 x2|
|Specimen Collection Details|
|Collection:||Total of six tubes collected: Four 4.5 mL light blue top tubes (sodium citrate) AND one 4 mL lavender top tube (EDTA) AND one 5 mL red top tube or 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. For STAT, refrigerate whole blood in unopened 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 to produce PLT CT less than 10,000 per cumm) and using a plastic pipette, transfer the top 2/3 of the plasma into 3-4 plastic vials. Label each tube of citrated plasma 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.” The EDTA tube must be submitted as unopened refrigerated whole blood. Send to the laboraotry within 7 days. If multiple tests are ordered, freeze a separate aliquot for this test.|
|Stability:||Original tubes: 4 hours refrigerated; citrated plasma: 7 days frozen; whole blood: 7 days refrigerated.|
|Standard Volume:||Four 4.5 mL light blue top tubes (or 4 mL plasma) AND one 4 mL lavender top tube (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 one 4 mL lavender top tube (whole blood) AND one 5 mL red top (or 1 mL serum).|
|Transport:||Original tubes refrigerated if sent STAT; citrated plasma frozen on dry ice; whole blood and serum refrigerated.|
|Rejection Criteria:||Frozen whole blood; visible fibrin; 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.