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Test Code CTR Congenital Thrombotic Risk Panel

Useful For

The congenital thrombotic risk panel is used to identify or rule out congenital deficiencies of natural coagulation inhibitory proteins or mutated procoagulants associated with a high incidence of thrombotic disease.

Synonyms/Keywords

Hypercoagulability, Thrombophilia, PROTSI, PROT-CF, PTG, ATIII, FVL

Specimen Requirements

Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
Whole Blood and *Platelet Poor Citrated Plasma EDTA Lavender Top Tube (LTT) and 3.2% Citrated Blue Top Tube (BTT)   2.0 mL EDTA whole blood and 4.5 mL citrated plasma divided into six 0.75 mL aliquots   1.0 mL EDTA whole blood and 2.25 mL citrated plasma divided into three 0.75 mL aliquots

Collection/Processing Instructions

Citrated Blue Top Tube (BTT) plasma: 

  • Collect in approximately 2-3 Citrated Blue Top Tubes (BTT).  
  • 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
Whole Blood Ambient 24 Hours
Refrigerated ≤ 15 Days
Frozen ≤ 3 Months
Plasma Frozen (-70oC) 6 Months

Rejection Criteria

Clotted or Hemolyzed
Contamination with IV or Hickman Line fluids
Specimens that thaw during storage or transport

Test Components

Antithrombin III, Functional (ATIII), Protein C Activity (PROT-CF), Free Protein S Antigen, Factor V Leiden Mutation (FVL), Prothrombin Gene Mutation (PTG). 

Test Information

The panel includes Antithrombin III, Protein C Activity, Free Protein S Antigen, Factor V Leiden Mutation, and Prothrombin Gene Mutation. This panel measures the natural inhibitor proteins, antithrombin, protein C, and protein S. If the protein C activity is reduced a Protein C Antigen (PROT-CI) will be performed.  If the free protein S antigen is reduced, protein S activity may be ordered upon pathologist approval. The panel also identifies the mutated procoagulants factor V Leiden and prothrombin 20210A. DNA analysis is performed to identify the mutated form of Factor V and the prothrombin gene mutation. An interpretation of test results is provided.

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 ATIII: Monday - Friday Less than 2 hours Chromogenic/Siemens CS 2500
PROTCF: Monday and Thursday Less than 2 hours Chromogenic/ACL TOP 550
PTG: Monday - Friday 6-8 hours Genetic Mutation
FVL: Monday - Friday 6-8 hours Genetic Mutation 
PROTSI: Monday and Thursday 2-4 hours Liatest/IL ACL TOP 550

 

CPT Codes

CPT Modifier
(if needed)		 Quantity Description Comments
85300     Antithrombin III. Functional  
85303     Protein C Activity (Functional)  
85306     Protein S Free Antigen  
81240     Prothrombin Gene Mutation  
85302     Protein C Antigen, Total (if needed)  
81241     Factor V Leiden  
85390     Pathology special coag interpretation  

Outreach CPT Codes

CPT Modifier
(if needed)		 Quantity Description Comments
85300     Antithrombin III. Functional  
85303     Protein C Activity (Functional)  
85306     Protein S Free Antigen  
81240     Prothrombin Gene Mutation  
85302     Protein C Antigen, Total (if needed)  
81241     Factor V Leiden (if needed)  
85390     Pathology special coag interpretation  

Ordering Applications

 

Ordering Application Description
Cerner Congenital Thrombotic Risk Panel