ARUP's Laboratory Test Directory

Lupus Anticoagulant Reflexive Panel : 0030181

Mnemonic: LUPUS R

Ordering Recommendation: Use for unexplained prolonged PTT or for patients with a significant probability of having antiphospholipid syndrome (APS). For APS, order with anticardiolipin (aCL) (0099344) and anti-beta-2-glycoprotein 1 (anti-β2GP1) (0050321) antibody IgG and IgM assays.
Methodology: Clotting
Performed: Sun-Sat
Reported: 1-2 days
Specimen Required: Collect: Light blue (sodium citrate). Refer to Specimen Handling at aruplab.com for hemostasis/thrombosis specimen handling guidelines.

Specimen Preparation: Transfer 2 mL platelet-poor plasma to an ARUP Standard Transport Tube. (Min: 1 mL)

Storage/Transport Temperature: CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered.

Unacceptable Conditions: Serum. Anticoagulants other than indicated. Clotted, hemolyzed, or non-frozen specimens.

Stability (collection to initiation of testing): Ambient: 4 hours; Refrigerated: 4 hours; Frozen at -20°C or below: 3 months; Frozen at -70°C or below: 18 months
Reference Interval:
 
Test Number Components Reference Interval
 Prothrombin Time 12.0-15.5 seconds
 Partial Thromboplastin Time 32-48 seconds
 Dilute Russell Viper Venom Time (dRVVT) 33-44 seconds
 Thrombin Time 14.7-19.5 seconds
 Reptilase Time Less than 22.0 seconds
 PTT Heparin Neutralized 32-48 seconds
 Partial Thromboplastin Time 1:1 Mix (performed if PTT > 48 seconds) 32-48 seconds
 Platelet Neutralization Procedure (performed if PTT 1:1 Mix > 48 seconds) Negative
 Dilute Russell Viper Venom (dRVVT) 1:1 Mix (performed if dRVVT > 44 seconds) 33-44 seconds
 Dilute Russell Viper Venom Time (dRVVT) Confirmation Test (performed if dRVVT 1:1 Mix > 44 seconds) Negative
 Hexagonal Phospholipid Neutralization Negative

Note: If PTT and dRVVT are normal, then no further testing is performed. If PTT is abnormal, Thrombin Time is added. If Thrombin Time is normal, PTT 1:1 mix is added.  If Thrombin time is abnormal, Reptilase Time and PTT Heparin Neutralization is added. If PTT Heparin Neutralization is abnormal, PTT 1:1 mix is added.  If PTT 1:1 mix is abnormal, Platelet Neutralization procedure is added. If dRVVT is abnormal, dRVVT 1:1 mix is added. If dRVVT 1:1 mix is abnormal, dRVVT confirmation is added. If Platelet Neutralization procedure and dRVVT confirmation are normal or if one is normal and the other not done, Hexagonal Phospholipid Neutralization is added. Additional charges apply.
CPT Code(s): 85610 Prothrombin time (PT); 85730 Partial Thromboplastin Time (PTT); 85613 dRVVT. If PTT is abnormal, add 85670 Thrombin Time. If Thrombin time is abnormal, add 85635 Reptilase Time. If Reptilase Time is normal, add PTT Heparin Neutralization 85730 and 85525. If PTT Heparin Neutralization is abnormal, add 85732 PTT 1:1 mix. If PTT 1:1 mix is abnormal, add 85597 Platelet neutralization procedure (PNP). If dRVVT is abnormal, add 85613 dRVVT 1:1 mix. If dRVVT 1:1 mix is abnormal, perform 85613 dRVVT confirmation. If PNP and dRVVT conf are normal, add 85598 Hexagonal Phospholipid Neutralization.
Cross References: Lupus 1 (Lupus Anticoagulant Reflexive Panel), Lupus Anticoagulant Comprehensive (Lupus Anticoagulant Reflexive Panel), Lupus Inhibitor (Lupus Anticoagulant Reflexive Panel)