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HelpTest Code CAPS Comprehensive Antiphospholipid Syndrome
Useful For
Determine the presence of antiphospholipid antibodies that may be associated with an increased risk for arterial or venous thrombosis or obstetric complications.
Synonyms/Keywords
CAPS, Anti-Phospholipid Antibodies, Anticardiolipin Antibodies, Antiphospholipid Antibodies, Cardiolipin, Cardiolipin Antibodies, Antiphospholipid syndrome, APS, anti-B2-GP1 antibodies, Beta 2 glycoprotein, Beta-2 glycoprotein, Beta-2 GP1, systemic lupus erythematosus, SLE
Specimen Requirements
| Note: Serum and Platelet Poor Plasma required | |||
|---|---|---|---|
| Specimen Type |
Preferred Container/Tube | Acceptable Container/Tube | Specimen Volume |
| Serum | Red Top Tube (RTT) | Serum Separator Tube (SST) | 1.0 mL serum aliquot |
| *Platelet Poor Plasma | 3.2% Citrated Blue Top Tube (BTT) | 3-4 1.5 mL aliquots of citrated plasma (see Collection Processing Instructions) | |
Collection/Processing Instructions
Serum (RTT or SST): Samples collected in a RTT must be removed from the clot within one hour for storage or transport. Samples collected in an SST must be processed and serum removed from the primary tube within 4 hours for storage or transport.
Citrated Plasma (BBT): Collect in approximately 3-4 Citrated Blue Top Tubes (BTT), aliquot each.
- Citrate anticoagulant must be adjusted for HCT >55%.
- Tube must be at least 90% full.
- Invert completely 3-4 times (without shaking) to mix.
*See Instructions for: Preparation of Platelet Poor Plasma
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated | 2 days |
| Frozen | 6 months | |
| Plasma | Ambient | 4 hours |
| Refrigerated | 4 hours | |
| Frozen | 6 months |
Rejection Criteria
| Clotted or Hemolyzed |
|---|
| Contamination with IV or Hickman Line fluid |
| Specimens that thaw during storage or transport |
Test Components
Antiphospholipid Antibodies (APLSAB), PT and APTT, Dilute Russell Viper Venom Time (DRVVT), Silica Clotting Time (SCT), Comp Antiphospholipid Interpretation (CAPSINT)
Test Information
Prothrombin Time, Activated Partial Thromboplastin Time, Dilute Russell Viper Venom Time (DRVVT), Silica Clotting Time (SCT) and Antiphospholipid Antibodies (APLSAB) will be performed. If the PT and/or APTT are prolonged mixing studies will be performed. Reflex testing for factor assays will be performed based on the results of PT (INR) and/or APTT mixing studies and the basic coagulation scheme.
Requested panel includes Lupus anticoagulant testing (DRVVT and SCT), these tests should not be performed on patients receiving rivaroxaban, apixaban, dabigatran, edoxaban, or warfarin. For patients on these medications, order the Antiphospholipid Antibodies (APLSAB) individually instead of the panel.
Interpretations
Prothrombin Time, Activated Partial Thromboplastin Time, Dilute Russell Viper Venom Time (DRVVT), Silica Clotting Time (SCT) and Antiphospholipid Antibodies (APLSAB) will be performed. If the PT and/or APTT are prolonged mixing studies will be performed. Reflex testing for factor assays will be performed based on the results of PT (INR) and/or APTT mixing studies and the basic coagulation scheme.
Requested panel includes Lupus anticoagulant testing (DRVVT and SCT), these tests should not be performed on patients receiving rivaroxaban, apixaban, dabigatran, edoxaban, or warfarin. For patients on these medications, order the Antiphospholipid Antibodies (APLSAB) individually instead of the panel.
Reference Range Information
| Performing Location | Reference Range |
|---|---|
| Marshfield | See individual test listings for reference ranges. |
Marshfield Labs Performing Department
Marshfield Labs Coagulation
Performing Information
| Performing Location | Day(s) Test Performed | Analytical Time | Methodology/Instrumentation |
|---|---|---|---|
| Marshfield |
PT, APTT: Monday - Friday | Less than 2 hours | Siemens CS Series |
| DRVVT: Monday and Thursday | Less than 2 hours | Optical clot detection/ACL Top 550 | |
| SCT: Monday and Thursday | Less than 2 hours | Optical clot detection/ACL Top 550 | |
| Mixing study/Factor Assays if needed: Monday and Thursday | Less than 2 hours | Siemens Sysmex CS2500 | |
| APLSAB: Monday - Friday | 2 to 4 hours | Multiplex Flow Immunoassay/Bio-Rad Bioplex 2200 |
CPT Codes
| CPT | Modifier (if needed) |
Quantity | Description | Comments |
|---|---|---|---|---|
| 85610 | Protime/INR | |||
| 85730 | APTT | |||
| 85613 | DRVVT | |||
| 85732 | SCT | |||
| 86146 | 3 | Antiphospholipid Antibodies (Beta 2 Glycoproteins IgA, IgG, IgM) | ||
| 86147 | 3 | Antiphospholipid Antibodies (Cardiolipin Antibodies IgA, IgG, IgM) |
|
|
| 85390 | Pathology special coag interpretation | |||
| Varies | Factor assays vary with follow-up |
|
Outreach CPT Codes
| CPT | Modifier (if needed) |
Quantity | Description | Comments |
|---|---|---|---|---|
| 85610 | Protime/INR | |||
| 85730 | APTT | |||
| 85613 | DRVVT | |||
| 85732 | SCT | |||
| 86146 | 3 | Antiphospholipid Antibodies (Beta 2 Glycoproteins IgA, IgM, IgM) | ||
| 86147 | 3 | Antiphospholipid Antibodies (Cardiolipin Antibodies IgA, IgG, IgM) |
|
|
| 85390 | Pathology special coag interpretation | |||
| Varies | Factor assays vary with follow-up |
Ordering Applications
| Ordering Application | Description |
|---|---|
| Cerner | CAPS Powerplan  |
| 4medica | Comprehensive Antiphospholipid Syndrome [CAPS] |