Nijmegen Factor IX (9) Inhibitor Profile
Test Summary
Modified Bethesda assay using buffered pooled plasma and factor deficient substrate that is more sensitive and specific. See Factor IX Inhibitor Profile for more details.
Aliases
- N/A
Specimen Collection
Special Instructions
See Link and Print "Drug List for Special Coagualtion Tests"
Preferred Specimen
6 plastic (2.7mL) completely filled 3.2% Sodium Citrate (light blue top) tubes
Minimum Volume
3 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. Sodium Citrate (light blue top) tube(s): 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 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. Sodium Citrate (light blue top) tube(s): 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 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
Whole blood Sodium Citrate (light blue top) tube(s)
OR
Frozen - Capped aliquots of Sodium Citrate plasma (Polypropylene tubes recommended)
OR
Frozen - Capped aliquots of Sodium Citrate plasma (Polypropylene tubes recommended)
Transport Temperature
Room Temperature: Whole blood Sodium Citrate (light blue top) tube(s)
Refrigerated: Unacceptable for Sodium Citrate (light blue top) tubes whole blood or capped plasma aliquots
Frozen: Capped aliquots of Sodium Citrate plasma
Refrigerated: Unacceptable for Sodium Citrate (light blue top) tubes whole blood or capped plasma aliquots
Frozen: Capped aliquots of Sodium Citrate plasma
Specimen Stability
- Room Temperature: Whole blood Sodium Citrate (light blue top) tube(s) <
- 4 hours
- Refrigerated: Unacceptable for Sodium Citrate (light blue top) tubes whole blood or capped plasma aliquots
- Frozen: Capped aliquots of Sodium Citrate plasma (Polypropylene tubes recommended) <
- 30 days at <
- &minus
- 20oC
Limitations
Anti-coagulant medications
Other Acceptable Specimens
N/A
Unacceptable Specimens
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.
Order Code
NF9INP
EPIC (Premier) Code
LAB5946
Includes
Nijmegen Factor IX Inhibitor titer
Factor IX activity level
Thrombin Clotting Time (TCT)
PT
PT 1:1 mix (reflexes to this if PT is prolonged)
APTT
If APTT is prolonged then it will reflex to the following mixes and incubations:
APTT 1:1 mix Immediate, 1 hour at 37⁰C, and 2 hours at 37⁰C
APTT 1:4 mix Immediate, 1 hour at 37⁰C, and 2 hours at 37⁰C
Pathology Interpretation
Factor IX activity level
Thrombin Clotting Time (TCT)
PT
PT 1:1 mix (reflexes to this if PT is prolonged)
APTT
If APTT is prolonged then it will reflex to the following mixes and incubations:
APTT 1:1 mix Immediate, 1 hour at 37⁰C, and 2 hours at 37⁰C
APTT 1:4 mix Immediate, 1 hour at 37⁰C, and 2 hours at 37⁰C
Pathology Interpretation
CPT Code
- 85250
- 85335
- 85610
- 85611
- 85730
- 85732(6)
- 85670
Billing Code
- 500349
- 300490
- 300482
- 300492
- 300445
CPT Statement
Methodology
Clot Based
FDA Status
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
Department
Hematology
Reference Range
See Report
Setup Schedule / Expected Turnaround Time
Monday - Friday; SCOAG; Report available: Same day testing if samples received by 12:00pm (noon); 1 - 3 days final report
Specimen Collection
Special Instructions
See Link and Print "Drug List for Special Coagualtion Tests"
Preferred Specimen
6 plastic (2.7mL) completely filled 3.2% Sodium Citrate (light blue top) tubes
Minimum Volume
3 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. Sodium Citrate (light blue top) tube(s): 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 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. Sodium Citrate (light blue top) tube(s): 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 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
Whole blood Sodium Citrate (light blue top) tube(s)
OR
Frozen - Capped aliquots of Sodium Citrate plasma (Polypropylene tubes recommended)
OR
Frozen - Capped aliquots of Sodium Citrate plasma (Polypropylene tubes recommended)
Transport Temperature
Room Temperature: Whole blood Sodium Citrate (light blue top) tube(s)
Refrigerated: Unacceptable for Sodium Citrate (light blue top) tubes whole blood or capped plasma aliquots
Frozen: Capped aliquots of Sodium Citrate plasma
Refrigerated: Unacceptable for Sodium Citrate (light blue top) tubes whole blood or capped plasma aliquots
Frozen: Capped aliquots of Sodium Citrate plasma
Specimen Stability
- Room Temperature: Whole blood Sodium Citrate (light blue top) tube(s) <
- 4 hours
- Refrigerated: Unacceptable for Sodium Citrate (light blue top) tubes whole blood or capped plasma aliquots
- Frozen: Capped aliquots of Sodium Citrate plasma (Polypropylene tubes recommended) <
- 30 days at <
- &minus
- 20oC
Limitations
Anti-coagulant medications
Other Acceptable Specimens
N/A
Unacceptable Specimens
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.
Billing
CPT Code
- 85250
- 85335
- 85610
- 85611
- 85730
- 85732(6)
- 85670
Billing Code
- 500349
- 300490
- 300482
- 300492
- 300445
CPT Statement
Result Information
Methodology
Clot Based
Testing Laboratory
N/A
Reference Range
See Report
Setup Schedule / Expected Turnaround Time
Monday - Friday; SCOAG; Report available: Same day testing if samples received by 12:00pm (noon); 1 - 3 days final report