AntiPhospholipid Screen
Test Summary
Lupus Anticoagulants are acquired circulating inhibitors, usually IgG immunoglobulin, but sometimes IgM or IgA. Due to the wide variability of phospholipid activity among patients, there is no single test that will detect the presence of Lupus Anticoagulants. Therefore, multiple assays using reagents with varying amounts of phospholipids are used to detect the presence of Lupus Anticoagulants. Venous as well as arterial thrombosis may occur in patients with Lupus Anticoagulants. Lupus Anticoagulant antibodies occur in various clinical conditions, including autoimmune diseases, unexplained thrombosis and recurrent spontaneous abortions and fetal demise.
Aliases
- N/A
Specimen Collection
Special Instructions
See Link and Print "Drug List for Special Coagualtion Tests"
Preferred Specimen
1 K2EDTA (lavender top) tubes
1 SST (speckled top) tubes OR 2 GST (gold top) tubes
4 plastic (2.7mL) completely filled 3.2% Sodium Citrate (light blue top) tubes
1 SST (speckled top) tubes OR 2 GST (gold top) tubes
4 plastic (2.7mL) completely filled 3.2% Sodium Citrate (light blue top) tubes
Minimum Volume
1 K2EDTA (lavender top) tube
3 Frozen Capped aliquots of at least 0.5mL serum (Polypropylene tubes recommended)
AND
4 Frozen Capped aliquots of Sodium Citrate plasma (Polypropylene tubes recommended)
3 Frozen Capped aliquots of at least 0.5mL serum (Polypropylene tubes recommended)
AND
4 Frozen Capped aliquots of Sodium Citrate plasma (Polypropylene tubes recommended)
Instructions
Use standard venipuncture and disposal techniques.
Collect the required quantity of Sodium Citrate (light blue top) tubes. If unable to process specimens within 4 hours of collection then call CompuNet transportation for a STAT pick-up at (937) 297-8262 option 1.
K2EDTA lavender tube: Keep as whole blood (do not spin) and maintain at room temperature.
SST/GST tube: Avoid hemolysis.
1. Invert a minimum of 5 times, and then allow clotting in an upright position for 30 minutes.
2. Centrifuge the SST/GST for at 3000 rpm for 10 minutes.
3. Spun SST/GST tube remains at refrigerated temperature (2-8 degrees C) for transport up to 72 hours for
4. Serum must be removed from original SST/GST tube and frozen at <-20 degrees C in plastic polypropylene aliquot tubes within 72 hours of collection. Refer to the Minimum Volume section above for the number of aliquots required per test.
Sodium Citrate (light blue top) tubes: Process immediately (stable only 4 hours), following instructions below: Note: We recommend aliquot tubes to be made of polypropylene plastic as this material is safe to freeze at <-70 degrees C.
1. Centrifuge capped Sodium Citrate (light blue top) tubes at 3000 rpm for 10 minutes, or at speed and time required to consistently produce Platelet Poor Plasma (<5/kmm3).
2. Carefully remove the plasma from all Sodium Citrate (light blue top) tubes; avoid disturbing the WBC/buffy coat, and combine all plasma into a plastic conical centrifuge tube. Note: If the plasma shows any hemolysis, it must be recollected.
3. Centrifuge the plasma in the plastic conical centrifuge tube for a second time as in step 1.
4. In one smooth motion, carefully and quickly pour the centrifuged plasma into a second 15mL plastic conical centrifuge tube. A small amount of plasma along with a red cell button should remain on the bottom of the original conical tube if the pour was executed correctly. Note: This quick-pour method prevents platelet transfer and contamination.
5. Aliquot at least 1mL of plasma into each aliquot tubes labeled “plasma.” Refer to the Minimum Volume section above for the number of aliquots required per test.
6. Finally, place all aliquots into a <-20°C freezer within 4 hours. Note: Aliquots must remain frozen until they are picked up by the CompuNet courier. Call CompuNet transportation department if frozen specimen boxes are needed.
Collect the required quantity of Sodium Citrate (light blue top) tubes. If unable to process specimens within 4 hours of collection then call CompuNet transportation for a STAT pick-up at (937) 297-8262 option 1.
K2EDTA lavender tube: Keep as whole blood (do not spin) and maintain at room temperature.
SST/GST tube: Avoid hemolysis.
1. Invert a minimum of 5 times, and then allow clotting in an upright position for 30 minutes.
2. Centrifuge the SST/GST for at 3000 rpm for 10 minutes.
3. Spun SST/GST tube remains at refrigerated temperature (2-8 degrees C) for transport up to 72 hours for
4. Serum must be removed from original SST/GST tube and frozen at <-20 degrees C in plastic polypropylene aliquot tubes within 72 hours of collection. Refer to the Minimum Volume section above for the number of aliquots required per test.
Sodium Citrate (light blue top) tubes: Process immediately (stable only 4 hours), following instructions below: Note: We recommend aliquot tubes to be made of polypropylene plastic as this material is safe to freeze at <-70 degrees C.
1. Centrifuge capped Sodium Citrate (light blue top) tubes at 3000 rpm for 10 minutes, or at speed and time required to consistently produce Platelet Poor Plasma (<5/kmm3).
2. Carefully remove the plasma from all Sodium Citrate (light blue top) tubes; avoid disturbing the WBC/buffy coat, and combine all plasma into a plastic conical centrifuge tube. Note: If the plasma shows any hemolysis, it must be recollected.
3. Centrifuge the plasma in the plastic conical centrifuge tube for a second time as in step 1.
4. In one smooth motion, carefully and quickly pour the centrifuged plasma into a second 15mL plastic conical centrifuge tube. A small amount of plasma along with a red cell button should remain on the bottom of the original conical tube if the pour was executed correctly. Note: This quick-pour method prevents platelet transfer and contamination.
5. Aliquot at least 1mL of plasma into each aliquot tubes labeled “plasma.” Refer to the Minimum Volume section above for the number of aliquots required per test.
6. Finally, place all aliquots into a <-20°C freezer within 4 hours. Note: Aliquots must remain frozen until they are picked up by the CompuNet courier. Call CompuNet transportation department if frozen specimen boxes are needed.
Patient Preparation
N/A
Storage
K2EDTA lavender top tube(s)
SST (speckled top) tube or GST (gold top) tube(s)
Whole blood Sodium Citrate (light blue top) tubes
OR
Frozen- Capped aliquots of at least 0.5mL serum (Polypropylene tubes recommended)
Frozen- Capped aliquots of Sodium Citrate plasma (Polypropylene tubes recommended)
SST (speckled top) tube or GST (gold top) tube(s)
Whole blood Sodium Citrate (light blue top) tubes
OR
Frozen- Capped aliquots of at least 0.5mL serum (Polypropylene tubes recommended)
Frozen- Capped aliquots of Sodium Citrate plasma (Polypropylene tubes recommended)
Transport Temperature
Room Temperature: K2EDTA lavender top tube(s)
Whole blood Sodium Citrate (light blue top) tubes
Refrigerated: SST (speck
Whole blood Sodium Citrate (light blue top) tubes
Refrigerated: SST (speck
Specimen Stability
- Room Temperature: K2EDTA (lavender top) tubes < 24 hours
- Whole blood Sodium Citrate (light blue top) tubes < 4 hours
- Refrigerated: K2EDTA (lavender top) tubes < 48 hours
- SST (speckled top) tube or GST (gold top) tubes < 72hours Phospholipid Antibodies
- Unacceptable for Sodium Citrate (light blue top) tubes whole blood or capped plasma aliquots
- Frozen: Capped aliquots of at least 0.5mL serum (Polypropylene tubes recommended): < 30 days at < -20⁰C or 12 months at < -70⁰C
- Capped aliquots of Sodium Citrate plasma (Polypropylene tubes recommended) < 30 days at < -20⁰C or 6 months at < -70⁰C
Limitations
Anti-coagulant medications and Hemolysis
Other Acceptable Specimens
N/A
Unacceptable Specimens
Sodium Citrate Plasma: Rejected for hemolysis, clotted, improper fill, incorrect specimen type, thawed frozen aliquots, refrigerated plasma or blood, expired test tubes, >4 hours old if not processed into separated frozen plasma vials.
EDTA lavender top tube: Rejected for gross hemolysis and received frozen.
Serum: Hemolysis, Lipemia, incorrect specimen type, insufficient sample volume, improper storage conditions, exceeds specimen stability guidelines, contaminated sample.
EDTA lavender top tube: Rejected for gross hemolysis and received frozen.
Serum: Hemolysis, Lipemia, incorrect specimen type, insufficient sample volume, improper storage conditions, exceeds specimen stability guidelines, contaminated sample.
Order Code
APLUSC
EPIC (Premier) Code
LAB4414
Includes
Phospholipid Antibodies:
Beta 2 Glycoprotein Abs IgG, IgM, IgA
Cardiolipin Abs IgG, IgM, IgA
Lupus Anticoagulant Assay:
Screening tests performed are Platelet Count, PT, APTT, DRVVT, Kaolin Clotting Time, PTT LA Screen and Thrombin Time. If any part of assay is abnormal then reflex testing is performed with additional charges.
Beta 2 Glycoprotein Abs IgG, IgM, IgA
Cardiolipin Abs IgG, IgM, IgA
Lupus Anticoagulant Assay:
Screening tests performed are Platelet Count, PT, APTT, DRVVT, Kaolin Clotting Time, PTT LA Screen and Thrombin Time. If any part of assay is abnormal then reflex testing is performed with additional charges.
CPT Code
- 85670
- 85613
- 85347
- 85610
- 85730(2)
- 86146(3)
- 86147(3)
- 85049 (Possible Reflex 85732(2)
- 85613
- 85598
- 85597
- 85611
- 85210
- 85220
- 85230
- 85260
- 85240
- 85250
- 85270)
Billing Code
- 300490
- 300485
- 300461
- 300482
- 300492
- 300511
- 300510
- 300434
CPT Statement
Methodology
Clot Based, ELISA
FDA Status
FDA Approved; PNP test is performed if not FDA approved.
Physician Attestation of Informed Consent
N/A
Testing Laboratory
CompuNet Clinical Laboratories, LLC
2308 Sandridge Drive
Moraine OH, 45439
2308 Sandridge Drive
Moraine OH, 45439
Reference Range
See Sample Report
Setup Schedule / Expected Turnaround Time
Lupus Anticoagulant Assay: Monday, Thursday. Phospholipid ABs; Monday, Tuesday, Thursday, Friday; SCOAG; Report available: 1 - 6 days
Specimen Collection
Special Instructions
See Link and Print "Drug List for Special Coagualtion Tests"
Preferred Specimen
1 K2EDTA (lavender top) tubes
1 SST (speckled top) tubes OR 2 GST (gold top) tubes
4 plastic (2.7mL) completely filled 3.2% Sodium Citrate (light blue top) tubes
1 SST (speckled top) tubes OR 2 GST (gold top) tubes
4 plastic (2.7mL) completely filled 3.2% Sodium Citrate (light blue top) tubes
Minimum Volume
1 K2EDTA (lavender top) tube
3 Frozen Capped aliquots of at least 0.5mL serum (Polypropylene tubes recommended)
AND
4 Frozen Capped aliquots of Sodium Citrate plasma (Polypropylene tubes recommended)
3 Frozen Capped aliquots of at least 0.5mL serum (Polypropylene tubes recommended)
AND
4 Frozen Capped aliquots of Sodium Citrate plasma (Polypropylene tubes recommended)
Instructions
Use standard venipuncture and disposal techniques.
Collect the required quantity of Sodium Citrate (light blue top) tubes. If unable to process specimens within 4 hours of collection then call CompuNet transportation for a STAT pick-up at (937) 297-8262 option 1.
K2EDTA lavender tube: Keep as whole blood (do not spin) and maintain at room temperature.
SST/GST tube: Avoid hemolysis.
1. Invert a minimum of 5 times, and then allow clotting in an upright position for 30 minutes.
2. Centrifuge the SST/GST for at 3000 rpm for 10 minutes.
3. Spun SST/GST tube remains at refrigerated temperature (2-8 degrees C) for transport up to 72 hours for
4. Serum must be removed from original SST/GST tube and frozen at <-20 degrees C in plastic polypropylene aliquot tubes within 72 hours of collection. Refer to the Minimum Volume section above for the number of aliquots required per test.
Sodium Citrate (light blue top) tubes: Process immediately (stable only 4 hours), following instructions below: Note: We recommend aliquot tubes to be made of polypropylene plastic as this material is safe to freeze at <-70 degrees C.
1. Centrifuge capped Sodium Citrate (light blue top) tubes at 3000 rpm for 10 minutes, or at speed and time required to consistently produce Platelet Poor Plasma (<5/kmm3).
2. Carefully remove the plasma from all Sodium Citrate (light blue top) tubes; avoid disturbing the WBC/buffy coat, and combine all plasma into a plastic conical centrifuge tube. Note: If the plasma shows any hemolysis, it must be recollected.
3. Centrifuge the plasma in the plastic conical centrifuge tube for a second time as in step 1.
4. In one smooth motion, carefully and quickly pour the centrifuged plasma into a second 15mL plastic conical centrifuge tube. A small amount of plasma along with a red cell button should remain on the bottom of the original conical tube if the pour was executed correctly. Note: This quick-pour method prevents platelet transfer and contamination.
5. Aliquot at least 1mL of plasma into each aliquot tubes labeled “plasma.” Refer to the Minimum Volume section above for the number of aliquots required per test.
6. Finally, place all aliquots into a <-20°C freezer within 4 hours. Note: Aliquots must remain frozen until they are picked up by the CompuNet courier. Call CompuNet transportation department if frozen specimen boxes are needed.
Collect the required quantity of Sodium Citrate (light blue top) tubes. If unable to process specimens within 4 hours of collection then call CompuNet transportation for a STAT pick-up at (937) 297-8262 option 1.
K2EDTA lavender tube: Keep as whole blood (do not spin) and maintain at room temperature.
SST/GST tube: Avoid hemolysis.
1. Invert a minimum of 5 times, and then allow clotting in an upright position for 30 minutes.
2. Centrifuge the SST/GST for at 3000 rpm for 10 minutes.
3. Spun SST/GST tube remains at refrigerated temperature (2-8 degrees C) for transport up to 72 hours for
4. Serum must be removed from original SST/GST tube and frozen at <-20 degrees C in plastic polypropylene aliquot tubes within 72 hours of collection. Refer to the Minimum Volume section above for the number of aliquots required per test.
Sodium Citrate (light blue top) tubes: Process immediately (stable only 4 hours), following instructions below: Note: We recommend aliquot tubes to be made of polypropylene plastic as this material is safe to freeze at <-70 degrees C.
1. Centrifuge capped Sodium Citrate (light blue top) tubes at 3000 rpm for 10 minutes, or at speed and time required to consistently produce Platelet Poor Plasma (<5/kmm3).
2. Carefully remove the plasma from all Sodium Citrate (light blue top) tubes; avoid disturbing the WBC/buffy coat, and combine all plasma into a plastic conical centrifuge tube. Note: If the plasma shows any hemolysis, it must be recollected.
3. Centrifuge the plasma in the plastic conical centrifuge tube for a second time as in step 1.
4. In one smooth motion, carefully and quickly pour the centrifuged plasma into a second 15mL plastic conical centrifuge tube. A small amount of plasma along with a red cell button should remain on the bottom of the original conical tube if the pour was executed correctly. Note: This quick-pour method prevents platelet transfer and contamination.
5. Aliquot at least 1mL of plasma into each aliquot tubes labeled “plasma.” Refer to the Minimum Volume section above for the number of aliquots required per test.
6. Finally, place all aliquots into a <-20°C freezer within 4 hours. Note: Aliquots must remain frozen until they are picked up by the CompuNet courier. Call CompuNet transportation department if frozen specimen boxes are needed.
Patient Preparation
N/A
Storage
K2EDTA lavender top tube(s)
SST (speckled top) tube or GST (gold top) tube(s)
Whole blood Sodium Citrate (light blue top) tubes
OR
Frozen- Capped aliquots of at least 0.5mL serum (Polypropylene tubes recommended)
Frozen- Capped aliquots of Sodium Citrate plasma (Polypropylene tubes recommended)
SST (speckled top) tube or GST (gold top) tube(s)
Whole blood Sodium Citrate (light blue top) tubes
OR
Frozen- Capped aliquots of at least 0.5mL serum (Polypropylene tubes recommended)
Frozen- Capped aliquots of Sodium Citrate plasma (Polypropylene tubes recommended)
Transport Temperature
Room Temperature: K2EDTA lavender top tube(s)
Whole blood Sodium Citrate (light blue top) tubes
Refrigerated: SST (speck
Whole blood Sodium Citrate (light blue top) tubes
Refrigerated: SST (speck
Specimen Stability
- Room Temperature: K2EDTA (lavender top) tubes < 24 hours
- Whole blood Sodium Citrate (light blue top) tubes < 4 hours
- Refrigerated: K2EDTA (lavender top) tubes < 48 hours
- SST (speckled top) tube or GST (gold top) tubes < 72hours Phospholipid Antibodies
- Unacceptable for Sodium Citrate (light blue top) tubes whole blood or capped plasma aliquots
- Frozen: Capped aliquots of at least 0.5mL serum (Polypropylene tubes recommended): < 30 days at < -20⁰C or 12 months at < -70⁰C
- Capped aliquots of Sodium Citrate plasma (Polypropylene tubes recommended) < 30 days at < -20⁰C or 6 months at < -70⁰C
Limitations
Anti-coagulant medications and Hemolysis
Other Acceptable Specimens
N/A
Unacceptable Specimens
Sodium Citrate Plasma: Rejected for hemolysis, clotted, improper fill, incorrect specimen type, thawed frozen aliquots, refrigerated plasma or blood, expired test tubes, >4 hours old if not processed into separated frozen plasma vials.
EDTA lavender top tube: Rejected for gross hemolysis and received frozen.
Serum: Hemolysis, Lipemia, incorrect specimen type, insufficient sample volume, improper storage conditions, exceeds specimen stability guidelines, contaminated sample.
EDTA lavender top tube: Rejected for gross hemolysis and received frozen.
Serum: Hemolysis, Lipemia, incorrect specimen type, insufficient sample volume, improper storage conditions, exceeds specimen stability guidelines, contaminated sample.
Billing
CPT Code
- 85670
- 85613
- 85347
- 85610
- 85730(2)
- 86146(3)
- 86147(3)
- 85049 (Possible Reflex 85732(2)
- 85613
- 85598
- 85597
- 85611
- 85210
- 85220
- 85230
- 85260
- 85240
- 85250
- 85270)
Billing Code
- 300490
- 300485
- 300461
- 300482
- 300492
- 300511
- 300510
- 300434
CPT Statement
Result Information
Methodology
Clot Based, ELISA
Testing Laboratory
N/A
Reference Range
See Sample Report
Setup Schedule / Expected Turnaround Time
Lupus Anticoagulant Assay: Monday, Thursday. Phospholipid ABs; Monday, Tuesday, Thursday, Friday; SCOAG; Report available: 1 - 6 days