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25509 Heparin Induced Thrombocytopenia Diagnostic Cascade

Heparin Induced Thrombocytopenia Diagnostic Cascade
Test Code: HITDC
Synonyms/Keywords
​Platelet Factor 4 ELISA for Heparin Antibodies, Heparin Induced Antibody, Heparin Dependent Platelet Antibody, HIT, Serotonin, PF4
Useful For
​Evaluating patients with unexplained thrombocytopenia and diagnosing (or excluding) heparin-induced thrombocytopenia.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)​​
​No ​Serum ​Red Top Tube (RTT) Serum Separator Tube (SST)​ 3.0 mL ​2.0 mL ​2.0 mL
Collection Processing Instructions
​Specimen needs to be received in the performing section by 1:30pm for same day results.
Specimen Stability Information
Specimen Type Temperature Tim​​e
​Serum ​ ​Refrigerate ​2 days
​Freeze ​> 2 days
Rejection Criteria
​
Specimens with heparin contamination​
Plasma​
Heparinized tubes​
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentat​​ion
​Marshfield ​Batched; run at 1:30pm each day ​2-3 days ​Enzyme Immunoassay (EIA)
Reference Range Information

< 0.400 OD: NEGATIVE: This result has approximately 90-95% negative predictive value for excluding heparin-induced thrombocytopenia (HIT).

0.400 – 1.000: EQUIVOCAL: Further testing with the Serotonin Release Assay (SRA) has been ordered and will be performed by the Blood Center of Wisconsin. Results should be available within 4 days. Most results in this range are not confirmed by SRA. Consider repeat testing if the clinical situation remains unclear.

> 1.000: POSITIVE: Heparin dependent antibodies are present. This result has reasonably good correlation with the Serotonin Release Assay (SRA). Serotonin Release Assay (SRA) has been ordered and will be performed by the Blood Center of Wisconsin. Results should be available within 4 days. If the clinical situation warrants, initiating treatment for heparin-induced thrombocytopenia (HIT) is reasonable.

As a stand-alone test, the SRA test will only be available by pathologist approval.

Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description C​​omments
​86022 ​ ​1 ​Platelet Factor 4 ELISA for Heaprin Antibodies ​
​86022 ​ ​1 Serotonin, send-out to Blood Center ​If needed
Synonyms/Keywords
​Platelet Factor 4 ELISA for Heparin Antibodies, Heparin Induced Antibody, Heparin Dependent Platelet Antibody, HIT, Serotonin, PF4
Ordering Applications
Ordering Application Description​​
​Centricity ​Heparin Induced Thrombocytopen
​Clinical Order Manager ​Heparin Induced Thrombocytopen
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)​​
​No ​Serum ​Red Top Tube (RTT) Serum Separator Tube (SST)​ 3.0 mL ​2.0 mL ​2.0 mL
Collection Processing
​Specimen needs to be received in the performing section by 1:30pm for same day results.
Specimen Stability Information
Specimen Type Temperature Tim​​e
​Serum ​ ​Refrigerate ​2 days
​Freeze ​> 2 days
Rejection Criteria
​
Specimens with heparin contamination​
Plasma​
Heparinized tubes​
Useful For
​Evaluating patients with unexplained thrombocytopenia and diagnosing (or excluding) heparin-induced thrombocytopenia.
Reference Range Information

< 0.400 OD: NEGATIVE: This result has approximately 90-95% negative predictive value for excluding heparin-induced thrombocytopenia (HIT).

0.400 – 1.000: EQUIVOCAL: Further testing with the Serotonin Release Assay (SRA) has been ordered and will be performed by the Blood Center of Wisconsin. Results should be available within 4 days. Most results in this range are not confirmed by SRA. Consider repeat testing if the clinical situation remains unclear.

> 1.000: POSITIVE: Heparin dependent antibodies are present. This result has reasonably good correlation with the Serotonin Release Assay (SRA). Serotonin Release Assay (SRA) has been ordered and will be performed by the Blood Center of Wisconsin. Results should be available within 4 days. If the clinical situation warrants, initiating treatment for heparin-induced thrombocytopenia (HIT) is reasonable.

As a stand-alone test, the SRA test will only be available by pathologist approval.

For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentat​​ion
​Marshfield ​Batched; run at 1:30pm each day ​2-3 days ​Enzyme Immunoassay (EIA)
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description C​​omments
​86022 ​ ​1 ​Platelet Factor 4 ELISA for Heaprin Antibodies ​
​86022 ​ ​1 Serotonin, send-out to Blood Center ​If needed
For most current information refer to the Marshfield Laboratory online reference manual.