Geisinger Medical Laboratories/Geisinger Proven Diagnostics Test Catalog

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

SOLUBLE FIBRIN MONOMERS

ORDERING INFORMATION:
Geisinger Epic Procedure Code: LAB3072         Geisinger Epic ID: 7159

SPECIMEN COLLECTION
Specimen type:
 Platelet-free 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 plasma; minimum 1 mL.
Special notes:
  • If the patient’s hematocrit (HCT) is >55%, the volume of anticoagulant in the tube should be adjusted. Contact a performing location for special tube preparation to reduce the citrate in the collection tube. For those patients with HCT >65.4% see LAB3632 Stago Sodium Citrate Adjustment Chart for formula to determine amount of citrate removal required.
  • When possible, use fresh venipuncture to collect blood to avoid activation of coagulation by tissue thromboplastin. Blood may be drawn from an indwelling catheter or vascular access device. Draw sample from a lumen that has not been heparinized or flush the line with 5 mL of saline, and discard or use for other purposes the first 5-10 mL of blood.
  • Butterfly device collections, draw a discard tube first to remove air from collection tubing.
  • Tubes should be >90% filled.
  • Immediately mix gently after collection by inverting the tube end over end 5 to 6 times. Avoid vigorous mixing or additional inversion. Observe for the presence of clots. Recollect if fibrin clots observed.
  • Immediately transport at room temperature to Coagulation Laboratory aftaer collection.
SPECIMEN PROCESSING
Specimen processing instructions:
Centrifuge within 60 minutes at designated speed and time to obtain platelet-poor plasma (<10,000/µL) and submit platelet free plasma. 
Transport temperature:
 Room temperature. DO NOT FREEZE.
Specimen stability:
 Stable for 2 hours at 15-25ºC.
Rejection criteria:
 Clotted specimen or underfilled or overfilled tube. Stability limits exceeded. HCT > 55%.
TEST DETAILS
Reference interval:
 Negative.
CPT code(s):
 85366
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.
Methodology:
Qualitative hemagglutination
Synonyms:
Fibrin Monomer, Soluble Fibrin Monomers, SFM
Clinical significance:
The assay can assist in diagnosing disseminated intravascular coagulation (DIC). Fibrin monomers are produced as soluble fibrinogen is transformed into insoluble fibrin clot. This intermediate product can form soluble complexes with fibrinogen or fibrinogen degradation products when thrombin levels are low (commonly observed in patients with DIC). These soluble complexes are then visualized using RBC agglutination. DIC is a clinical diagnosis, and no single test should be used to diagnose DIC. This assay should be correlated with other DIC tests (PT, APTT, D-Dimer, and platelet count). In neonates, interpret samples with caution, as the results are often positive, due to difficulty in sample collection.
Doctoral Director(s:)
Michelle Grant DO    
Review Date: 02/09/2023

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: Mary Glazenski    
Frequency: Daily, all shifts    
Performed STAT? Yes

Geisinger Community Medical Center

Performing laboratory: Coagulation
Technical Lead: Robert Furcon  
Frequency: Daily, all shifts    
Performed STAT? Yes
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