Antiphospholipid (Cardiolipin) Syndrome Reflex Panel

Specimen:

Test Code

ANTPHS

Specimen Name

Antiphospholipid (Cardiolipin) Syndrome Reflex Panel

Collect

4-Blue Top (Na Citrate); 1-SST

Submit

2 mLs (Min: 2 mLs) Plasma CRITICAL FROZEN and 1 mL (Min: 0.6 mL) Serum Frozen

Special Handling

Seperarte plasma and serum from cell ASAP. Transfer plasma and serum to transport tubes and label appropriately.

Rejection Criteria

For Lupus Anticoagulant Reflexive Panel (Plasma): Serum. EDTA plasma, clotted or hemolyzed specimens. For cardiolipin and beta-2 glycoprotein antibodies (serum): Plasma and other body fluids, heat-inactivated, hemolyzed, lipemic, or contaminated specimens.

Stability

Plasma: Ambient 4 hours; Refrigerated Unacceptable; Frozen at -20 or below: 3 months and Serum: Ambient 48 hours; Refrigerated 2 weeks; Frozen 1 year (avoid repeated freeze/thaw cycles)

Methodology

Chromogenic Assay / Semi-Quantitative Enzyme-Linked Immunosorbent Assay (ELISA) / Electromagnetic Mechanical Clot Detection

Performed

Sunday - Saturday

Reported

2-5 days

CPT Codes

  • 85610
  • 85613
  • 85730
  • 86147 x2
  • 86146 x2
  • if reflexed
  • additional CPT codes may apply: 85520
  • 85525
  • 85598
  • 85613
  • 85670
  • 85730.

Components

Panel includes: Beta-2 Glycoprotein 1 Antibodies, IgG and IgM; Cardiolipin Antibodies, IgG and IgM; and Lupus Anticoagulant Reflex Panel: if PTT-LA Ratio and dRVVT Screen Ratio are normal, then no further clot-based testing is performed. If either the PTT-LA Ratio or dRVVT Screen Ratio are elevated, then Anti-Xa Qualitative Interpretation is added. If PTT-LA Ratio is elevated, then Thrombin Time is also added. If Anti-Xa Qualitative Interpretation is Present and Thrombin Time is greater than 30 seconds, then Hepzyme treatment is added. If PTT-LA Ratio is normal and Anti-Xa Qualitative Interpretation is Present, or Thrombin Time is greater than 30 seconds, and Anti-Xa Qualitative Interpretation is Not Present, or Thrombin Time is less than 30 seconds, and Anti-Xa Qualitative Interpretation is Present, then DOAC-Stop treatment is added. If either Hepzyme or DOAC-Stop treatment is added, then Neutralized PTT-LA Ratio and/or Neutralized dRVVT Screen Ratio are added. If dRVVT Screen Ratio is elevated in the absence of Hepzyme or DOAC-Stop, or if Neutralized dRVVT Screen Ratio is elevated, then dRVVT 1:1 Mix Ratio and dRVVT Confirmation Ratio are added. If PTT-LA Ratio is elevated in the absence of Hepzyme or DOAC-Stop treatment, or if Neutralized PTT-LA Ratio is elevated, then Hexagonal Phospholipid Confirmation is added. Additional charges apply.

Additional Information

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Common Lab Definitions

  • Serum 
  • Plasma 
  • STT