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23412 Factor 5 (V) Leiden Profile

Factor 5 (V) Leiden Profile
Test Code: FVLPROF
Synonyms/Keywords
APCR Resistance Ratio, APCRR, Protein C Resistance, FV R506Q, Factor V Leiden Mutation Test​
Test Components
Activated Protein C Resistance (APCRR)​
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
*Platelet Poor Plasma
and
Whole Blood
 3.2% Citrated Blue Top Tube (BTT) and EDTA Lavender Top Tube (LTT)​ Whole blood in 3.2% Citrated Blue Top Tube (BTT) 0.75 mL plasma and 2.0 mL whole blood​ 0.75 mL plasma and 0.3 mL whole blood​ 0.5 mL  plasma and 150 uL  whole blood​
Collection Processing Instructions

​Patient must not be receiving low molecular weight or unfractionated heparin - recommend performing Factor V Leiden Mutation (FVL) in those cases.

Citrated Plasma (BTT):
If more than one coagulation test is ordered, a separate aliquot is needed for each test.
-Collect in Citrated Blue Top Tube (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

Whole Blood: 
EDTA or citrated whole blood (lavender or blue top tube).  The whole blood specimen tube must not be opened prior to analysis.  Uncentrifuged specimens preferred.

Specimen Stability Information
Specimen Type Temperature Time
​Plasma ​Frozen ​6 months
​Whole Blood ​Refrigerate ​10 days
Rejection Criteria
Clotted or Hemolyzed
​Contamination with IV or Hickman Line Fluids
​Specimens That Thaw During Storage or Transport
​FVL: Whole Blood Specimen Tubes That Have Been Opened
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Marshfield ​ ​APCR: Wednesday ​Less than 2 hours Optical clot detection /Siemens BCSXP​
​FVL: Thursday ​ PCR/Hybridization Probe​
Test Information
An Activated Protein C Resistance (APCR) will be performed.  If the Activated Protein C Ratio (APCR) is <2.2 a Factor V Leiden (FVL) will be performed. 
See Clinical Practice Guidelines for more information​
Reference Range Information
Performing Location Reference Range
​Marshfield See individual test listings for reference ranges​
Interpretation

​An APCR of <2.2 is suggestive of the Factor V Leiden Defect. This must be confirmed by DNA Testing for the mutation (FVL).
Heterozygous for Factor V Leiden: the relative risk of venous thrombosis is about 7-fold that of the general population. Other conditions, either acquired or inherited, may act synergistically to increase an individual's thrombotic risk.
Homozygous for Factor V Leiden: the relative risk of venous thrombosis is about 70-fold that of the general population. Other conditions, either acquired or inherited, may act synergistically to increase an individual's thrombotic risk.

Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​85307 ​ ​ ​APCR ​
​81241 ​ ​ ​Factor V Leiden gene analysis (if needed) ​
Synonyms/Keywords
APCR Resistance Ratio, APCRR, Protein C Resistance, FV R506Q, Factor V Leiden Mutation Test​
Test Components
Activated Protein C Resistance (APCRR)​
Ordering Applications
Ordering Application Description
​Centricity

​Factor 5 (V) Leiden Profile

or

Factor V Leiden Profile

​Cerner ​Factor V Leiden Profile
​COM ​Factor 5 (V) Leiden Profile
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
*Platelet Poor Plasma
and
Whole Blood
 3.2% Citrated Blue Top Tube (BTT) and EDTA Lavender Top Tube (LTT)​ Whole blood in 3.2% Citrated Blue Top Tube (BTT) 0.75 mL plasma and 2.0 mL whole blood​ 0.75 mL plasma and 0.3 mL whole blood​ 0.5 mL  plasma and 150 uL  whole blood​
Collection Processing

​Patient must not be receiving low molecular weight or unfractionated heparin - recommend performing Factor V Leiden Mutation (FVL) in those cases.

Citrated Plasma (BTT):
If more than one coagulation test is ordered, a separate aliquot is needed for each test.
-Collect in Citrated Blue Top Tube (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

Whole Blood: 
EDTA or citrated whole blood (lavender or blue top tube).  The whole blood specimen tube must not be opened prior to analysis.  Uncentrifuged specimens preferred.

Specimen Stability Information
Specimen Type Temperature Time
​Plasma ​Frozen ​6 months
​Whole Blood ​Refrigerate ​10 days
Rejection Criteria
Clotted or Hemolyzed
​Contamination with IV or Hickman Line Fluids
​Specimens That Thaw During Storage or Transport
​FVL: Whole Blood Specimen Tubes That Have Been Opened
Test Components
Activated Protein C Resistance (APCRR)​
Reference Range Information
Performing Location Reference Range
​Marshfield See individual test listings for reference ranges​
Interpretation

​An APCR of <2.2 is suggestive of the Factor V Leiden Defect. This must be confirmed by DNA Testing for the mutation (FVL).
Heterozygous for Factor V Leiden: the relative risk of venous thrombosis is about 7-fold that of the general population. Other conditions, either acquired or inherited, may act synergistically to increase an individual's thrombotic risk.
Homozygous for Factor V Leiden: the relative risk of venous thrombosis is about 70-fold that of the general population. Other conditions, either acquired or inherited, may act synergistically to increase an individual's thrombotic risk.

For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Marshfield ​ ​APCR: Wednesday ​Less than 2 hours Optical clot detection /Siemens BCSXP​
​FVL: Thursday ​ PCR/Hybridization Probe​
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​85307 ​ ​ ​APCR ​
​81241 ​ ​ ​Factor V Leiden gene analysis (if needed) ​
For most current information refer to the Marshfield Laboratory online reference manual.