ARUP's Laboratory Test Directory

0030268: Thrombotic Risk (Acquired) Reflexive Panel

Test Mnemonic: HYPERCOAG
Methodology: Refer to individual components

Performed: Refer to individual components

Reported: Refer to individual components

Specimen Required:  
Collect: One 5 mL lt. blue (sodium citrate) for lupus, AND one 5 mL lt. blue (sodium citrate) d-dimer (Min: 3 mL), AND one 6 mL SST for cardiolipin (Min: 4 mL), AND one 5 mL green (sodium or lithium heparin) for homocysteine. 

Transport: Two 2 mL aliquots of platelet-poor plasma (lt. blue, sodium citrate) in two ARUP Standard Transport Tubes, frozen for lupus and d-dimer, AND one 2 mL serum, frozen for cardiolipin, AND one 1 mL plasma, frozen for homocysteine; in ARUP Standard Transport Tube.

Pediatric Collection/Transport: Refer to individual components.

Unacceptable Conditions: Refer to individual components.

Stability: Refer to individual components.

Reference Interval:
 
Test Number Components Reference Interval
 Prothrombin Time 12.0-15.5 seconds
0030232Partial Thromboplastin Time 32-48 seconds
 Dilute Russell Viper Venom Time (dRVVT) 33-44 seconds
0050901Cardiolipin Antibody, IgG < 15 GPL: Absent or none detected
15-19 GPL: Inconclusive
20-79 GPL: Moderate positive
³ 80 GPL: High positive 
0050902Cardiolipin Antibody, IgM < 12 MPL: Absent or none detected
12-19 MPL: Inconclusive
20-79 MPL: Moderate positive
³ 80 MPL: High positive
0030057D-Dimer 0.0-0.4 µg/mL
0099869Homocysteine, Total Male:  4-12 µmol/L
Female:  4-10 µmol/L 
 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) 0.0-7.0 seconds
 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) Less than 1.34
 Hexagonal Phospholipid Neutralization Negative

Interpretive Data:
Refer to individual components.



Note:
If PTT is elevated, then PTT 1:1 mix will be added. If PTT 1:1 mix is elevated, then platelet neutralization test will be added.  If dRVVT is elevated, then dRVVT 1:1 mix will be added. If the dRVVT 1:1 mix is elevated, then the dRVVT confirmation test will be added. 

CPT Code(s):
85610 PT-D; 85730 PTT-D; 85613 dRVVT; 86147 X2 Cardiolipin G/M; 85379 D-dimer; 83090 Homocysteine.  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 85597 Hexagonal Phospholipid Neutralization.