Geisinger Medical Laboratories/Geisinger Proven Diagnostics Test Catalog

Order Display Name: Geisinger Epic Procedure Code Or ID CPT Code:  

PT INR

ORDERING INFORMATION:
Geisinger Epic Procedure Code: LAB2946         Geisinger Epic ID: 14539

SPECIMEN COLLECTION
Specimen type:
Platelet-poor plasma
Preferred collection container:
Alternate Collection Container:
Other size blue-top (3.2% sodium citrate) tubes (e.g., 1.8 mL, 4.5 mL)
Specimen required:
1 mL aliquot of platelet-poor plasma.
Special notes:
Perform venipuncture with no trauma. If blood is drawn from an indwelling catheter, flush with 5 mL of saline and discard the first 5 mL of blood collected to avoid contaminating sample with tissue thromboplastin or heparin. If blood is drawn with a butterfly device, draw a discard tube first to remove air from tubing.

SPECIMEN PROCESSING
Specimen processing instructions:
If specimen analyzed within 24 hours: Fresh whole blood.
If specimen analyzed after 24 hours: Frozen platelet poor plasma.
Centrifuge the citrated blue-top tubes at designated speed and time to obtain platelet-poor plasma (<10,000/µL). Using a plastic pipette, remove 1 mL of plasma and transfer to a plastic aliquot tube and label with patient's name and a second patient identifier (e.g., date of birth, medical record number). 
Transport temperature:
Whole blood: Room temperature.
Frozen plasma: Frozen on dry ice.
Specimen stability:
Whole blood: 24 hours at room temperature.
Plasma: -20°C for 30 days, -70°C for 6 months.
Rejection criteria:
Clotted, overfilled or underfilled tubes. Stability limits exceeded. HCT >55. HCT > 55 requires rejection, reorder in LIS, and recollection with proper adjustment of anticoagulant.

TEST DETAILS
Reference interval:
PT 11.6 – 15.2
INR 0.8 – 1.2
Critical values/courtesy alerts:
INR greater than 4.99.
Additional information:
Anticoagulation Impact on Coagulation Tests
CPT code(s):
85610
Note: The billing party has sole responsibility for CPT coding.  Any questions regarding coding should be directed to the payer being billed.  The CPT codes provided by GML are based on AMA guidelines and are for informational purposes only.
Test includes:
PT seconds, INR
Methodology:
Mechanical Clot-Based
Synonyms:
INR, PTINR
Protime/INR
Prothrombin Time
Prothrombin Time with International Normalized Ratio
Clinical significance:
Screening test to detect a deficiency/inhibitor of one or more clotting factors of the extrinsic and common clotting pathways (factor VII, X, V II, fibrinogen). Prolonged PT could indicate one or more deficiencies of plasma factors VII, X, V, II, and fibrinogen, and/or a possible inhibitor (factor dependent or lupus anticoagulant) as well as a vitamin K deficiency (from dietary or intestinal reabsorption disorders). Diseases often associated with prolong PT include liver failure, primary fibrinolysis and disseminated intravascular coagulopathy (DIC). Medications may also prolong PT including warfarin, other anticoagulants, oral contraceptives, nonsteroidal anti-inflammatory drugs, vitamin K, anticoagulants, and antibiotics.
Warfarin Therapeutic Ranges:
INR: 2.0-3.0 conventional anticoagulation
INR: 2.5-3.5 high intensity anticoagulation.
Doctoral Director(s:)
Michelle Grant DO    
Review Date: 09/19/2022

Performing Locations

Geisinger Medical Center

Performing laboratory: Coagulation
Technical Lead: Margaret Knowles-Tuchman
Frequency: Daily, all shifts
Performed STAT? Yes

Geisinger Wyoming Valley Medical Center

Performing laboratory: ATL+
Technical Lead: Julia Bell    
Frequency: Daily, all shifts    
Performed STAT? Yes

Geisinger Shamokin Area Community Hospital

Performing laboratory: Coagulation
Technical Lead: Kelly Alleman    
Frequency: Daily, all shifts    
Performed STAT? Yes

Geisinger Bloomsburg Hospital

Performing laboratory: Hematology
Technical Lead: Kristen Hall  
Frequency: Daily, all shifts    
Performed STAT? Yes

Geisinger Community Medical Center

Performing laboratory: Hematology
Technical Lead: Renee Bordo, Robert Furcon  
Frequency: Daily    
Performed STAT? Yes

Geisinger Lewistown Hospital

Performing laboratory: Hematology
Technical Lead: Lisa Sheaffer  
Frequency: All shifts    
Performed STAT? Yes

Geisinger Medical Center Muncy

Performing laboratory: Coagulation
Technical lead: Mariana Moyer    
Frequency: Daily, all shifts    
Performed STAT? Yes

Geisinger Jersey Shore Hospital

Performing laboratory: Coagulation
Technical lead:    
Frequency: Daily, all shifts    
Performed STAT? Yes

Geisinger South Wilkes-Barre

Technical lead: Bernadette Johnson    
Frequency: Daily, all shifts    
Performed STAT? Yes
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