Venous Thromboembolism Eval (VTH)

Department: Coagulation
Test Synonym(s): LAB5451, VTH, Hypercoagulable State Panel for Venous Thromboembolism
Test Components: PT/INR, PTT, TT, LMWH, PC and S activity, AT activity, FVL, G20210A. Reflex to FVL Mutation & AT, Protein C & S (free & total) as needed. 
CPT Codes: 85610, 85730, 85670, 85520, 85300, 85301, 85303, 85302, 85306, 8530x2, 85305, 85307, 81240, 81241
Methodology: Various: clotting, chromogenic, immu-turbidimetric, and direct detection of mutation R506Q and/or G20210A
Reference Range: See Individual Assays
Tube Type: 3 2.7mL Light blue top- 3.2% Sodium Citrate. Neonate: 3 1.8mL Light blue top - 3.2% sodium citrate.
Specimen: Whole blood or citrated platelet poor plasma: Requires double centrifugation if sending a plasma aliquot. Aliquots must be frozen. **If sending plasma aliquots, will also require one tube of the centrifuged red cell pellet. 
Pediatric Requirements: Pediatric: 3 2.7mL light blue top - 3.2% sodium citrate. Neonate: 3 1.8mL light blue top - 3.2% sodium citrate
Volume: 3.0 mL Citrated plasma
Minimum Volume: 3.0 mL Citrated plasma
Temperature: Room temperature for light blue top tubes. Must be received within 4 hours of collection. Plasma aliquots must be frozen.
Stability: 4 hours; Frozen (-70C): 1 month
Reasons for Rejection: Clotted, incorrectly filled tubes, incorrect tube type, grossly hemolyzed samples, grossly lipemic, grossly icteric plasma, whole blood > 4.0 post collection
Days Performed: Monday - Friday
Times Performed: Twice per week
TAT: 1 - 4 days
Significance: Anticoagulants interfere with the assays including: coumadin, LMWH, UFH, direct thrombin inhibitors and direct anti-Xa inhibitors.
Special Instructions: Deliver whole blood speciments to the lab immediately. Tubes must be filled to the indicator line and not clotted. Indwelling lines should be flushed with saline only and 5 mL of blood should be discarded prior to collecting samples for coagulation studies. If sending plasma aliquots: DOUBLE CENTRIFUGE plasma samples to produce platelet poor plasma. Specimens received from a VPLS client must be aliquoted and frozen. Grossly hemolyzed, lipemic or icteric samples may be rejected due to interference with assays. Ordering physician name and telephone contact information MUST accompany the sample and requests.

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