Medicare Medical Necessity Restrictions May Apply
Medical Necessity Documentation:
Client Notes:
If patient is on Unfractionated Heparin the specimen will need to be to the testing laboratory within 45 minutes of collection.
Patient Preparation:
Specimen Requirements:
2.7 mL Whole Blood in a Blue Top Tube - 3.2% Buffered Sodium Citrate
Collection Instructions:
Specimens must be filled appropriately see this example
Correct ratio of Blood to Citrate is critical (9:1). Specimens must be filled within +/- 10% of stated volume.
If a Blue Top Tube is collected utilizing a butterfly, a Blue Discard Tube must be drawn first to remove air from the line. If this is not done, the Blue Top Tube will not be filled properly due to the vacuum in tube and a redraw will be required
Heparinized Patient specimens must be spun within 1 hour of collection - Follow Platelet Poor Collection
Note: Collection of blood for coagulation testing through intravenous lines that have been previously flushed with heparin should be avoided, if possible.
If the blood must be drawn through an indwelling catheter, possible heparin contamination and specimen dilution should be considered.
When obtaining specimsn from indwelling lines that may contain heparin, the line should be flushed with 5mL of saline, and the first 5 mL of blood or 6-times the line volume
(dead space volume of the catheter) be drawn off and discarded before the coagulation tube is filled. For those samples collected from a normal saline lock (capped off venous port) twice the dead space volume of the catheter and extension set should be discarded.
Minimum Volume:
1.8 mL Whole Blood in a Clear Blue Top Tube
Neonatal Volume:
1.8 mL Whole Blood in a Clear Blue Top Tube
Transport & Storage: Temperature/Stability:
Unfractionated heparinized patient 4 hour Ambient
Non-heparinized patient 24 hours Ambient
Rejection Criteria:
Frozen in a Frost Free Freezer; over or under filled tubes; 3.8% Sodium Citrate; clotted; underfilled; overfilled; inappropriate temperature; HCT >55%; cell volume > 1/2 the tube volume; Re-frozen; Thawed specimens
Reference Range:
24.2 - 33.0 seconds
Therapeutic range for pre-mixed heparin is 50.0-70.0 seconds. seconds. Heparin therapeutic range is based on the APTT range corresponding to a heparin concentration of 0.3 to 0.7 Units/milliliter determined by Factor Xa inhibition assay.
Critical Ranges:
>= 110.0 Seconds
Test Comments:
Methodology:
Photo Optical
Clinical Significance:
Screening for deficiencies or inhibitors of the coagulation system.
Monitor the dosing effect of unfractionated heparin therapy.
Documentation:
Custom Panel:
No
PRODUCTION SCHEDULE
Stat Eligible:
Yes
Turn Around Time:
8 hours
Days Performed:
Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed:
Parkview Dekalb Hospital, Parkview Huntington Hospital, Parkview LaGrange Hospital, Parkview Noble Hospital, Parkview Randallia Hospital, Parkview Regional Medical Center, Parkview Southwest , Parkview Wabash Hospital, Parkview Warsaw , Parkview Whitley Hospital
PHL Test Code:
PTT
EPIC Test Code:
LAB325
Alternate Test Names:
APTT; Partial Thromboplastin Time; PTT
Included Tests:
CPT Coding:
85730