Geisinger Medical Laboratories/Geisinger Proven Diagnostics Test Catalog

Test Name: Sunquest Test Code Epic Procedure Code Or ID CPT Code:  

HEPARIN AB WITH REFLEX TO SEROTONIN RELEASE ASSAY IF POSITIVE

ORDERING INFORMATION:
Sunquest Test Code:
HITREF      Geisinger Epic Procedure Code: HITREF         Geisinger Epic ID: 46467

SPECIMEN COLLECTION
Specimen type:
Serum
Preferred collection container:
Alternate Collection Container:
6 mL red-top (plain, non-serum separator) tube
Specimen required:
1.5 mL aliquot serum; minimum 0.8 mL. Please submit a separate aliquot for the HITREF. It may not be combined with any other test.
Special notes:
For same day HITGAM testing, specimen must be received in GMC Immunology Lab by noon. Specimens received after that time will be tested on the next testing day.

SPECIMEN PROCESSING
Specimen processing instructions:
Allow serum to clot. Centrifuge and submit 1.5 ml aliquot of serum for HITREF in its own tube. 
Transport temperature:
Refrigerated.
Specimen stability:
Room temperature: 8 hours for HITGAM. Refrigerated (HITGAM orSERREL ): 48 hours. Frozen: 6 months. Do not send frozen unless two aliquots are submitted.
Rejection criteria:
Stability limits exceeded or grossly hemolyzed.

TEST DETAILS
Reference interval:
HITGAM <0.400; SERREL reference ranges and interpretation will accompany report.
Additional information:
HITGAM performed at GMC. If positive, SERREL sent to Quest reference laboratory.
CPT code(s):
86022 x 2
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:
HITGAM Polyspecific (IGG, IGA, IGM) antibody to platelet factor 4 with reflex to Serotonin Release Assay if positive.
Methodology:
Enzyme-Linked Immunosorbent Assay (ELISA)
Radio Binding 14C Serotonin Radiolabel
Synonyms:
Heparin-induced thrombocytopenia Ab to platelet factor 4 HIT, Anti-platelet factor 4, Anti-PF4 HAT, heparin-induced thrombocytopenia GAM Heparin-associated antibody. SERREL: Thrombocytopenia Quest test code 14627
Clinical significance:
Heparin-induced thrombocytopenia (HIT) is the most common form of drug-induced thrombocytopenia and can develop in up to 5% of patients treated with heparin. A presumptive diagnosis of HIT can be based on a > 50% reduction in platelet count more than 5 days after initiation of heparin therapy, a platelet count <150,000/uL or the development of thromboembolic complications
Doctoral Director(s:)
Stacy Kenyon, PhD, DABCC
Hoi-Ying Elsie Yu, PhD, DABCC    
Review Date: 10/31/2018

Performing Locations

Geisinger Medical Center

Performing laboratory: Immunology
Technical Lead: Kathy Hurst
Frequency: Sunday-Friday, first shift
Performed stat? No

Quest Diagnostics

Technical Lead: Michael Weaver    
Frequency: Monday-Friday morning    
Performed stat? No
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*GMC - Geisinger Medical Center; GWV - Geisinger Wyoming Valley Medical Center; GSACH - Geisinger Shamokin Area Community Hospital; GBH - Geisinger Bloomsburg Hospital;
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