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dRVVT Screen with Reflex to dRVVT Confirm and dRVVT 1:1 Mix [15780X]

Test Code

33693

CPT Code(s)

85613

Includes

If dRVVT Screen is prolonged (>45 seconds), dRVVT Confirm will be performed at an additional charge (CPT code(s): 85597).
If dRVVT Confirm is positive, dRVVT 1:1 Dilution will be performed at an additional charge (CPT code(s): 85613).

Preferred Specimen(s)

2 mL frozen platelet-poor plasma collected in a 3.2% sodium citrate (light blue-top) tube

Minimum Volume

1 mL

Collection Instructions

Please submit a separate, frozen vial for each special coagulation assay ordered.

Platelet Poor Plasma for Lupus Anticoagulant Testing: Perhaps the most important step in the diagnosis of the lupus anticoagulant (LA) is appropriate specimen collection and processing. It is imperative that the laboratory take extra precautions in preparing platelet-poor plasma (PPP). The more platelet-free the sample, the greater the sensitivity of most test systems to the presence of LA. Ideally, PPP should have a platelet count of less than 10 x 109 per liter (<10,000/mcL). Although the sample collection process described in the Coagulation Specimens in the Specimen Collection section of Test Directory should yield PPP, the following double-spin technique can also be used:

1. Spin down specimen at 1500 x g for 15 minutes.
2. Transfer the plasma to a plastic tube with a plastic Pasteur pipette, staying away from the buffy coat layer. Spin down the plasma portion again at 1500 x g for 15 minutes. With another plastic Pasteur pipette, transfer the plasma to another plastic tube, staying clear of the bottom of the tube where the platelets lie. Alternatively, the plasma may be filtered using a 0.2 micron filter.
3. Transfer plasma into a plastic tube using a plastic Pasteur pipette. Do not use glass tubes or glass Pasteur pipettes, as glass can activate the clotting cascade.
4. Label each tube plasma. Submit a plasma aliquot for each and every coagulation assay requested (one tube for each test). If possible, submit one additional plasma
aliquot for repeat and/or test additions.

Specimen Container

Plastic screw-cap vial

Transport Temperature

Frozen

Specimen Stability

Room temperature: Unacceptable
Refrigerated: Unacceptable
Frozen: 90 days

Reject Criteria

Hemolysis

Methodology

Clot Detection

Performing Laboratory

Quest Diagnostics Nichols Institute
14225 Newbrook Drive
Chantilly, VA 20153

Setup Schedule

Set up: Mon-Sat (night shift).; Report available: Next day

Reference Range(s)

dRVVT Screen ≤45 seconds
dRVVT Confirm Negative
dRVVT 1:1 Mix Corrected

Clinical Significance

Diagnosis of a lupus anticoagulant (LA) requires testing with a least 2 screening reagents, followed by confirmatory testing. The dRVVT screen, confirm, and mix satisfy international guidelines for LA evaluations.

LOINC®' Code(s)

The Result and LOINC information listed below should not be used for electronic interface maintenance with Quest Diagnostics. Please contact the Quest Diagnostics Connectivity Help Desk for more information at 800-697-9302.

NOTE: The codes listed in the table below are not orderable Test Codes.

Result
Code
Result NameLOINC CodeComponent Name
33693CdRVVT 1:1 Mix34569-4Coagulation dilute Russell viper venom induced.factor substitution^immediately after 1:2 addition of normal plasma
3369AdRVVT Screen6303-2Coagulation dilute Russell viper venom induced
3369CdRVVT6303-2Coagulation dilute Russell viper venom induced
3369IdRVVT Mix Interpretation:50008-2Mixing studies

Reference ranges are provided as general guidance only. To interpret test results use the reference range in the laboratory report.

The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

LOINC assignment is based on a combination of test attributes, including the method used by the performing laboratory. For tests not performed by Quest Diagnostics, codes are assigned by the performing laboratory.

* The tests listed by specialist are a select group of tests offered. For a complete list of Quest Diagnostics tests, please refer to our Directory of Services.