Hypercoagulation Laboratory Panel


Sunquest Code:Indiv Codes  
  Epic Name:Hypercoagulation Laboratory Panel
Order Instructions:Specific tests are ordered by provider in EPIC under order code O433022005 for outpatient and O3041311369 for inpatient.
CPT Code:----------CPTCODES HERE----------
Turnaround Time:See individual test codes.


Collection Instructions

Collection Instructions:See individual test codes.


Processing and Shipping

Specimen Processing:See individual test codes.
Test Performed at or Referral Lab Coagulation  (UMMC-East Bank)


Interpretive

Use:Provider Information:
  • Hypercoagulable testing is almost never indicated or helpful in the acute/inpatient setting.
  • Hypercoagulable testing should generally be reserved for patients with unprovoked and/or recurrent venous thromboembolism (VTE), a strong family history of VTE, age less than 45, clots in unusual locations, or history of warfarin-induced skin necrosis.
  • Acute thrombosis can reduce antithrombin, protein C and protein S levels.
  • Genetic tests can be ordered at the time of diagnosis, but almost never impact the initial management of an acute thrombotic event.
  • Anticoagulants can affect the results of some assays. Heparin may cause a physiologic decrease in antithrombin levels and warfarin may reduce protein S and protein C levels. Anticoagulants may result in false positive lupus anticoagulant results. Do not order lupus anticoagulant/inhibitor testing if the patient is on a direct thrombin inhibitor (e.g. dabigatran, argatroban, or bivalirudin) or direct Xa innhibitor (e.g., rivaroxaban, apixaban, betrixaban or edoxaban) or fondaparinux. Direct thrombin inhibitors may cause a false elevation in the antithrombin in the assay used in this laboratory. Direct thrombin inhibitors and direct Xa inhibitors may cause a false negative of the activated protein C resistance ratio.
  • There are other tests that MAY be indicated as part of a hypercoagulable workup, but such testing should only be done after consultation with Hematology.
Standard Testing for Genetic Thrombophilia includes:
  • Factor 2 Prothrombin and Factor 5 Leiden Mutation Analysis (order together or individually if one has already  been completed)
  • Protein C Chromogenic
  • Protein S Antigen, Free
  • Antithrombin III
  • Also draw INR and PTT if not drawn previously
Standard Testing for Acquired Thrombophilia includes:
  • Lupus Panel (anticoagulant/inhibitor)
  • Cardiolipin Antibody IgG and IgM
  • Beta-2-Glycoprotein Antibodies IgG and IgM
  • Also draw INR and PTT if not previously drawn
 


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