Thrombotic Risk, Congenital

CPT: 81240; 83090; 85300; 85303; 85306; 85307; 85420
Updated on 1/7/2019
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Specimen Requirements

Specimen

Plasma, frozen, and serum, refrigerated, and whole blood or buccal swab kit. (The buccal swab collection kit contains instructions for the use of a buccal swab.)

Volume

6 mL plasma, frozen (3 mL plasma into each of two tubes) and 2 mL serum and 7 mL whole blood or buccal swab

Minimum Volume

3 mL plasma, frozen and 1 mL serum and 3 mL whole blood or buccal swabs

Container

Blue-top (sodium citrate) tube, gel-barrier tube, lavender-top (EDTA) tube, yellow-top (ACD) tube, or LabCorp buccal swab kit

Patient Preparation

Do not draw from an arm with a heparin lock or heparin lock or heparinized catheter.

Collection

Citrated plasma samples should be collected by double centrifugation. Blood should be collected in a blue-top tube containing 3.2% buffered sodium citrate.1 Evacuated collection tubes must be filled to completion to ensure a proper blood-to-anticoagulant ratio.2,3 The sample should be mixed immediately by gentle inversion at least six times to ensure adequate mixing of the anticoagulant with the blood. A discard tube is not required prior to collection of coagulation samples.4,5 When noncitrate tubes are collected for other tests, collect sterile and nonadditive (red-top) tubes prior to citrate (blue-top) tubes. Any tube containing an alternate anticoagulant should be collected after the blue-top tubes. Gel-barrier tubes and serum tubes with clot initiators should also be collected after the citrate tubes. Centrifuge for 10 minutes and (using a plastic transfer pipette) carefully remove two-thirds of the plasma without disturbing the cells. Deliver to a plastic transfer tube, cap, and recentrifuge for 10 minutes. Use a second plastic pipette to remove the plasma, staying clear of the platelets at the bottom of the tube. Transfer the plasma into a LabCorp PP transpak frozen purple tube with screw cap (LabCorp N° 23751). The specimen should be frozen immediately and maintained frozen until tested. To avoid delays in turnaround time when requesting multiple tests on frozen samples, please submit separate frozen specimens for each test requested.

Please print and use the Volume Guide for Coagulation Testing to ensure proper draw volume.

Storage Instructions

Freeze plasma. Refrigerate serum. Maintain whole blood and buccal swab kit at room temperature or refrigerate.

Clinical Information

Footnotes

1. Adcock DM, Kressin DC, Marlar RA. Effect of 3.2% vs 3.8% sodium citrate concentration on routine coagulation testing. Am J Clin Pathol. 1997 Jan; 107(1):105-110. 8980376
2. Reneke J, Etzell J, Leslie S, Ng VL, Gottfried EL. Prolonged prothrombin time and activated partial thromboplastin time due to underfilled specimen tubes with 109 mmol/L (3.2%) citrate anticoagulant. Am J Clin Pathol. 1998 Jun; 109(6):754-757. 9620035
3. National Committee for Clinical Laboratory Standardization: Collection, Transport, and Processing of Blood Specimens for Coagulation Testing and General Performance of Coagulation Assays; Approved Guideline. 5th ed. Villanova, Pa: NCCLS; 2008. Document H21-A5:28(5).
4. Gottfried EL, Adachi MM. Prothrombin time and activated partial thromboplastin time can be performed on the first tube. Am J Clin Pathol. 1997 Jun; 107(6):681-683. 9169665
5. McGlasson DL, More L, Best HA, Norris WL, Doe RH, Ray H. Drawing specimens for coagulation testing: Is a second tube necessary? Clin Lab Sci. 1999 May-Jun; 12(3):137-139. 10539100

References

Alving BM. The antiphospholipid syndrome: Clinical presentation, diagnosis, and patient management. In: Kitchens CS, Alving BM, Kessler CM, eds. Consultative Hemostasis and Thrombosis. Philadelphia, Pa: WB Saunders Co; 2002:181-196.
Schafer AI, Levine MN, Konkle BA, Kearon C. Thrombotic disorders: Diagnosis and treatment. Hematology (Am Soc Hematol Educ Program). 2003: 520-539. 14633797
Triplett DA. Thrombophilia. In: McClatchey KD, ed. Clinical Laboratory Medicine. 2nd ed. Philadelphia, Pa: Lippincott Williams and Wilkins; 2002: 1033-1049.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
117706 Thrombotic Risk (Congenital) 707009 Homocyst(e)ine, Plasma umol/L 13965-9
117706 Thrombotic Risk (Congenital) 015040 Antithrombin Activity % 27811-9
117706 Thrombotic Risk (Congenital) 117705 Protein C-Functional % 27819-2
117706 Thrombotic Risk (Congenital) 117714 Plasminogen % 5970-9
117706 Thrombotic Risk (Congenital) 164519 Protein S, Free % 27821-8
117706 Thrombotic Risk (Congenital) 117763 Act.Prt.C Resist. ratio 13590-5
117706 Thrombotic Risk (Congenital) 117871 FVDNA TRACKING N/A
117706 Thrombotic Risk (Congenital) 511218 Factor II, DNA Analysis 24476-4
Reflex Table for Act.Prt.C Resist.
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 511260 Factor V Leiden Mutation 511262 Factor V Leiden 21667-1

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