Orderable EAP code:

LAB00070

Billable EAP Codes:

80001700 x 1

CPT Codes:

82248 x 1

Lab Section:

Core Lab

Turnaround Time:

Routine: 2 Hours

Urgent: 1 Hour

Test Schedule:

24 hours, 7 days a week.

Units:

mg/dL

Specimen Requirements:

4 mL blood in a GREEN top, lithium heparin tube. Protect specimen from light.

Stability: 

Serum/plasma is stable up to and including 3 days refrigerated at 4 degrees C in a serum separator tube.

Serum/plasma separated from the cells is stable up to and including 3 days at room temperature in the dark or up to and including 30 days refrigerated at 4 degrees C in the dark.

Pediatric Specimen Requirements:

0.5 mL in a 1.0 mL GREEN top, lithium heparin tube. Protect specimen from light.

Reference Range:

Less than or equal to 0.2 mg/dL

Synonyms:

Conjugated Bilirubin

Direct Bilirubin

Orderable EAP code:

LAB00005

Billable EAP Codes:

80001699 x 1

CPT Codes:

82247 x 1

Lab Section:

Core Lab

Turnaround Time:

Routine: 2 Hours

Urgent: 1 Hour

Test Schedule:

24 hours, 7 days a week.

Units:

mg/dL

Critical Values:

Cord Blood: greater than or equal to 3.5 mg/dL

Neonates: greater than or equal to 15 mg/dL

Specimen Requirements:

4 mL blood in a GREEN top, lithium heparin tube. Protect specimen from light.

Stability: 

Serum/plasma is stable up to and including 3 days refrigerated at 4 degrees C in a serum separator tube.

Serum/plasma separated from the cells is stable up to and including 3 days at room temperature in the dark or up to and including 30 days refrigerated at 4 degrees C in the dark.

Pediatric Specimen Requirements:

0.5 mL in a 1.0 mL GREEN top, lithium heparin tube.

Reference Range:

Up to 1 day old	1.4 to 8.7 mg/dL
1 day to 2 days old	3.4 to 11.5 mg/dL
2 days to 5 days old	1.5 to 12.0 mg/dL
5 days to 150 years old	0.3 to 1.2 mg/dL

 

Orderable EAP code:

LAB00569

Billable EAP Codes:

80001660 x 1

CPT Codes:

80307 x 1

Lab Section:

Core Lab

Includes:

Benzodiazepine

Turnaround Time:

Routine: 2 Hours

Test Schedule:

24 hours, 7 days a week.

Specimen Requirements:

6 mL urine in a sample cup.

Pediatric Specimen Requirements:

6 mL urine in a sample cup.

Reference Range:

Negative

Comments:

Benzodiazepine detected in urine at levels greater than or equal to 200 ng/mL are considered "positive."

"Positive" results are NOT confirmed by an alternate method. See: Summary of Compounds that may be detected by OHSU Drugs of Abuse Screening Methods. (Opens in a new window)

Synonyms:

Drug Screen

Drugs of Abuse

Urine Drug Screen

Orderable EAP code:

LAB00368

Billable EAP Codes:

80001654 x 1

CPT Codes:

80048 x 1

Lab Section:

Core Lab

Includes:

Na, K, Cl, BUN, Creat, Glu, CO2, Ca

Turnaround Time:

Routine: 2 Hours

Urgent: 1 Hour

Test Schedule:

24 hours, 7 days a week.

Critical Values:

See individual test listings for critical values.

Specimen Requirements:

4 mL blood in a GREEN top, lithium heparin tube.

Pediatric Specimen Requirements:

0.5 mL in a 1.0 mL GREEN top, lithium heparin tube.

Reference Range:

See individual test listings for reference ranges.

Synonyms:

Basic

BMP

BMS

BMT

Orderable EAP code:

LAB00574

Billable EAP Codes:

80001665 x 1

CPT Codes:

80307 x 1

Lab Section:

Core Lab

Includes:

Barbituates

Turnaround Time:

Routine: 2 Hours

Urgent: 1 Hour with verbal request

Test Schedule:

24 hours, 7 days a week.

Specimen Requirements:

6 mL urine cup.

Pediatric Specimen Requirements:

6 mL urine in sample cup or in 10 mL RED top tube.

Reference Range:

Negative

Comments:

Barbiturates detected in urine at levels greater than or equal to 200 ng/mL are considered "positive."

"Positive" results are not confirmed by alternate method. See: Summary of Compounds that may be detected by OHSU Drugs of Abuse Screening Methods. (Opens in a new window)

Synonyms:

Drug Screen

Drugs of Abuse

Urine Drug Screen

Orderable EAP code:

LAB00125

Billable EAP Codes:

80001791 x 1

CPT Codes:

84450 x 1

Lab Section:

Core Lab

Turnaround Time:

Routine: 2 Hours

Urgent: 1 Hour

Test Schedule:

24 hours, 7 days a week.

Units:

U/L

Specimen Requirements:

4 mL blood in a GREEN top, lithium heparin tube.

Pediatric Specimen Requirements:

0.5 mL blood in a 1.0 mL GREEN top, lithium heparin tube.

Reference Range:

0 up to 14 Days: less than or equal to 146 U/L

14 Days up to 1 Years: less than or equal to 61 U/L

1 Years up to 7 Years: less than or equal to 40 U/L

7 Years up to 12 Years: less than or equal to 33 U/L

12 Years up to 19 Years: less than or equal to 32 U/L

19 Years up to 150 Years: less than or equal to 39 U/L

Synonyms:

AST, SGOT

Orderable EAP code:

LAB00262

Lab Section:

Core Lab

Includes:

Assay reflexed to Lupus Inhibitor Evaluation if indicated.

Turnaround Time:

Routine: 2 Hours

Urgent: 1 Hour

Test Schedule:

Mixing studies received before 1:30 pm are processed the same day; after 1:30 pm, samples are processed the next day. Reflexed lupus testing is batched 2 times per week. Call 503-494-7383 if STAT.

Units:

Seconds

Specimen Requirements:

3 LIGHT BLUE top tubes, 3.2% sodium citrate or four (4) 1 mL frozen sodium citrate plasma aliquots. Tubes must be full (see comments below).

Pediatric Specimen Requirements:

3 pediatric 1.3 mL LIGHT BLUE top tube, 3.2% sodium citrate or one 1 mL aliquot of sodium citrate plasma. For pediatric patients requiring multiple coagulation tests, please call 503-494-7383 regarding draw volumes.

Reference Range:

Normal Pool, 0 min: 26.0 to 37.9 seconds.

Normal Pool, 60 min: 26.0 to 37.9 seconds.

Lupus studies, see lupus anticoagulant testing.

Comments:

Draw volume is critical due to the liquid anticoagulant. Allow tubes to fill by vacuum.

• Tubes with rubber stopper: fill to line on label.
• Tubes with plastic (Hemogard) cap: the fill level is above the top of the label.
• Syringe: do not remove the vacutainer stopper. Insert the needle through the stopper and allow the tube to fill by vacuum. Do not overfill the vacutainer.
• Pediatric tubes have no vacuum. Remove the cap and add blood to the 1.3 mL mark. Do not overfill.

Samples for mixing studies (Core lab) and lupus testing (Hemostasis & Thrombosis Lab) sodium citrate specimens must be processed and frozen within 2 hours of specimen collection. OHSU clinics must cab the specimen to the Core Lab, Hatfield Research Center, 9th Floor (room 9D20) if processing is delayed or not possible on site . A phone call is helpful to alert the lab at 503-494-7383. Detailed instructions are under Hemostasis & Thrombosis section (Opens in a new window).

Avoid warfarin (Coumadin) therapy for 2 weeks and heparin/DOAC/DTI therapy for 2 days prior to the test.

Patients with prolonged PTT will be reflexed for a heparin test. Mixes suggestive of an inhibitor will be reflexed for a lupus inhibitor evaluation.

The assay is used to distinguish between circulating inhibitor and coagulation factor deficiency when APTT is prolonged. Test is a screening test for the lupus anti-coagulant. Typically, a patient is identified with a prolonged APTT without a history of bleeding, or perhaps with a history of thrombosis or miscarriage. Failure to correct a prolonged APTT with 1:1 mix suggests a circulating inhibitor. A positive mixing study should be followed by studies to determine whether the inhibitor is a true antibody (i.e. anti-Factor VIII) or an anti-phospholipid antibody (lupus anticoagulant).

Methodology: Clot-based on prolongation of APTT assay.

Mixing studies performed on only mildly elevated partial thromboplastin times are often uninformative due to dilutional effects, therefore mixing studies will not be reflexively performed until the PTT is greater than 2 seconds longer than the upper limit of normal (i.e. greater than 38.9).

Synonyms:

1:1 Mix

50 M

50:50 Mix

PTT Mix

Orderable EAP code:

LAB00237

Billable EAP Codes:

80001089 x 1

CPT Codes:

85300 x 1

Lab Section:

Core Lab

Includes:

Assay is included with Hypercoaguable Panel

Turnaround Time:

Routine: 2 Hours

Urgent: 1 Hour

Test Schedule:

24 hours, 7 days a week.

Units:

%

Specimen Requirements:

3.2% sodium citrate tubes are acceptable provided they are filed to the line on the manufacturer's label. Tubes must be full (see comments below). Whole blood specimens are stable up to 8 hours at room temperature. Citrate plasma separated from cells is stable for up to 1 month at -20 degrees C. For referral testing, submit at least 1.0 mL frozen platelet poor citrated plasma.

Pediatric Specimen Requirements:

Add blood to the 1.3 mL mark of Pediatric BLUE top tube, 3.2% sodium citrate.

Reference Range:

Less than 1 month: 39% to 108%

1 month up to 3 months: 39% to 124%

3 months up to 6 months: 73% to 124%

6 months up to 1 year: 86% to 118%

1 year and greater: 83% to 128%

Comments:

Draw volume is critical due to the liquid anticoagulant. Allow tubes to fill by vacuum.

• Tubes with rubber stopper: fill to line on label.
• Tubes with plastic (Hemogard) cap: the fill level is above the top of the label.
• Syringe: do not remove the vacutainer stopper. Insert the needle through the stopper and allow the tube to fill by vacuum. Do not overfill the vacutainer.
• Pediatric tubes have no vacuum. Remove the cap and add blood to the 1.3 mL mark. Do not overfill.

Avoid heparin therapy for 2 days prior to the test.

Assay is used to evaluate hypercoagulable state, fibrinogenolytic state, and response to heparin. Test for the hereditary deficiency of antithrombin III (autosomal dominant) which is characterized by predisposition to thrombosis. Acquired deficiency associated with severe cirrhosis, chronic liver failutre, DIC, thrombolytic therapy, pulmonary embolism, nephrotic syndrome, or postsurgical state (especially liver transplant or partial hepatectomy) and due to decreased synthesis, increased loss/consumption, or induced by drugs must be excluded.

Limitations: Assay measures only functional activity. Presence of additional "antithrombins" (distinct from AT III, in particular heparin cofactor II) may contribute to functional "AT III" activity as determined variously by different clinical assays complicating their interpretation and comparability. If specimen contains heparin (as with specimen drawn after heparin flush or patient receiving heparin) results may be decreased. Patients receiving coumarin type anticoagulants may have increased AT III levels.

Methodology: Chromogenic

Decreased Antithrombin III Levels may be due to:

Use of oral contraceptives

Heparin therapy

Disseminated Intravascular coagulation (DIC)

Pulmonary embolism (PE)

Liver diseases

Nephrotic syndrome

Thrombophlebitis

Increased Antithrombin III levels may be due to:

Coumadin-type anticoagulation (low vitamin K)

Bleeding disorder

Kidney transplant

Use of anabolic steroids

Synonyms:

Coags

ATIII

AT III

Antithrombin III Activity

AT III Activity

AT3 Activity

Antithrombin III

Orderable EAP code:

LAB00003

Billable EAP Codes:

80001697 x 1

CPT Codes:

82150 x 1

Lab Section:

Core Lab

Turnaround Time:

Routine: 2 Hours

Urgent: 1 Hour with verbal request

Test Schedule:

24 hours, 7 days a week.

Units:

U/hr

Critical Values:

None

Specimen Requirements:

Timed urine collection. Refrigerate during collection.

Pediatric Specimen Requirements:

0.5 mL in 4 mL RED top tube or urine sample cup for random/spot requests

Reference Range:

1 to 17 U/hr

Orderable EAP code:

LAB00002

Billable EAP Codes:

80001696 x 1

CPT Codes:

82150 x 1

Lab Section:

Core Lab

Turnaround Time:

Routine: 2 Hours

Urgent: 1 Hour

Test Schedule:

24 hours, 7 days a week.

Units:

U/L

Critical Values:

Greater than or equal to 1000 U/L.

Specimen Requirements:

4 mL blood, GREEN top, lithium heparin tube.

Stability: Plasma/serum separated from cells stable up to and including 7 days at room temperature or 30 days refrigerated.

Pediatric Specimen Requirements:

0.5 mL in a 1.0 mL GREEN top, lithium heparin tube.

Reference Range:

29 to 103 U/L