Geisinger Medical Laboratories/Geisinger Proven Diagnostics Test Catalog

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

LUPUS ANTICOAGULANT PROFILE WITH INTERPRETATION BY PATHOLOGIST

ORDERING INFORMATION:
Geisinger Epic Procedure Code: LAB2625         Geisinger Epic ID: 26810

SPECIMEN COLLECTION
Specimen type:
Platelet-free plasma AND serum.
Preferred collection container:
Alternate Collection Container:
Other size blue-top (3.2% sodium citrate) tubes (e.g., 1.8 mL, 4.5 mL)
6 mL red-top (plain, non-serum separator) tube
Specimen required:
Three (3) 1 mL aliquots of platelet-free citrated plasma and one (1) 1 mL aliquot of serum.
Special notes:
Collect two (2) 2.7 mL blue-top tubes (3.2% sodium citrate) and one (1) 6 mL red-top tube (nonserum separator).
Patient preparation:
Hold heparin 48 hours; Coumadin 2 weeks, and direct oral anticoagulation (anti-X and anti-thrombin inhibitors for 7 days prior to testing; testing after an acute thrombosis or blood clot is not recommended as it may cause erroneous results.

SPECIMEN PROCESSING
Specimen processing instructions:
Centrifuge clotted red-top tube for 15 minutes at 2500 x g, 1 ml aliquot serum, and blue-top tubes at the designated speed and time to obtain platelet-poor plasma (< 10,000/uL). Remove plasma and re-spin the plasma for 10 minutes at 3000 rpm. Remove the supernatant platelet free plasma into (3) 1 mL aliquots, freeze and transport frozen. 
Transport temperature:
Three (3) aliquots of citrated plasma frozen. One (1) aliquot of serum refrigerated.
Specimen stability:
Frozen: -20°C for 30 days, -70°C for 6 months.
Rejection criteria:
Clotted specimen. Stability limits exceeded.

TEST DETAILS
Reference interval:
Lupus anticoagulant not detected, anticardiolipin antibodies negative, Beta-2-glycoprotein antibodies negative.
Additional information:
Testing includes interpretation with report.
CPT code(s):
85613, 85610, 85730, 86147 x3, Additional tests if indicated: 85525, 85611, 85597, 86146 x3
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:
Lupus sensitive APTT (PTT-LA), dilute Russel's viper venom time (DRVVT), beta-2-glycoprotein and anticardiolipin antibodies IgG and IgM calsses. Thrombin time, heparin anti-Xa level, heparin neutralization, LA Mixing studies, DRVVT Confirmation, and PTT-LA platelet neutralization if indicated..
Methodology:
See individual member listings.
Synonyms:
LUPACC, Lupus inhibitor panel with interpretation
Lupus anticoagulant panel with interpretation
Clinical significance:
Lupus anticoagulant and antiphospholipid antibodies (cardiolipin and beta-2 glycoprotein) have been observed in patients with antiphospholipid antibody syndrome, systemic lupus erythematous, or transiently in acute disease states. The diagnosis of antiphospholipid antibody syndrome requires a positive test in the lupus anticoagulant profile (lupus anticoagulant or detectable antiphospholipid antibody on two separate occasions at least 12 weeks apart, in the setting of arterial or venous thrombosis or (in women) complications of pregnancy (Table 1).

Table 1. Revised Sapporo Criteria of Antiphospholipid Antibody Syndrome


Clinical Criteria*

Laboratory Criteria**

Vascular thrombosis:
- venous, arterial, or small vessel

Detectable antiphospholipid antibody
- IgG or IgM cardiolipin antibody
- IgG or IgM beta-2-glycoprotein antibody

Pregnancy complication
- Unexplained fetal death at or after 10 weeks gestation
- 3 or more fetal deaths before 10 weeks gestation
- 1 premature births of normal neonate due to
  eclampsia, preeclampsia, or placental insufficiency

Lupus anticoagulant
- abnormal DRVVT confirmatory ratio
- abnormal lupus sensitive aPTT with abnormal platelet neutralization procedure)

*The thrombosis or pregnancy complication must occur within 5 years of positive test result

**At least one of the above tests must be positive on two separate occasions at least 12 weeks apart

Source: Miyakis S et al (2006).

Doctoral Director(s:)
Michelle Grant DO    
Review Date: 10/18/2022

Performing Locations

Geisinger Medical Center

Performing laboratory: Coagulation
Technical Lead: Margaret Knowles-Tuchman
Frequency: First shift, twice weekly
Performed STAT? No
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