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View Medical Necessity Guide
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Hexagonal Phase Confirmation
Last Modified:
10/5/2022 11:24:50 AM
Medical Necessity Documentation:
Client Notes:
Patient Preparation:
Specimen Requirements:
1.5 mL Platelet Poor Plasma from a
Blue Top Tube
- 3.2% Buffered Sodium Citrate in a Plastic Vial
Collection Instructions:
Centrifuge light blue-top tube 15 minutes at approximately 1500 g within 60 minutes of collection. Using a plastic pipette, remove plasma, taking care to avoid the WBC/platelet buffy layer and place into a plastic vial. Centrifuge a second time and transfer platelet-poor plasma into a new plastic vial. Plasma must be free of platelets (<10,000/mcL).
Minimum Volume:
0.5 mL Platelet Poor Plasma
Transport & Storage: Temperature/Stability:
Unacceptable Ambient
Unacceptable Refrigerated
90 days Frozen
Freeze immediately and ship on dry ice.
Rejection Criteria:
Received at room temperature or Refrigerated • Thawed plasma • Hemolysis
Reference Range:
Negative
Critical Ranges:
Test Comments:
Methodology:
Clot Detection
Clinical Significance:
This test is useful in determining the presence of the lupus anticoagulant that is associated with increased risk of thrombosis.
Documentation:
Custom Panel:
No
PRODUCTION SCHEDULE
Turn Around Time:
1 to 3 days
Days Performed:
Sunday, Monday, Tuesday, Wednesday, Thursday, Friday
Sites Performed:
Quest - Chantilly
PHL Test Code:
MSOT
EPIC Test Code:
MISC
Send Out Test Code:
36573
Included Tests:
CPT Coding:
85598
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