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24762 Congenital Thrombotic Risk Panel

Congenital Thrombotic Risk Panel
Test Code: CTR
Synonyms/Keywords
Hypercoagulability, Thrombophilia, PROTSI, PROT-CF, PTG, ATIII, FVL
Test Components
​Antithrombin III, Functional (ATIII), Protein C Activity (PROT-CF), Free Protein S Antigen, Factor V Leiden Mutation (FVL), Prothrombin Gene Mutation (PTG). 
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.
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 (-70) ​6 Months
Rejection Criteria
Clotted or Hemolyzed
​Contamination with IV or Hickman Line fluids
​Specimens that thaw during storage or transport
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ ​ ​ ​ ​ ​ ​ ​ ​ ATIII: Monday - Friday Less than 2 hours​ Chromogenic/Siemens CS 2500
PROTCF: Weekly 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: Tuesday and Friday​ 2-4 hours​ Liatest/IL ACL TOP 550
PROT-CI: Weekly​ 2-4 hours​ Liatest/IL ACL TOP 550
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.
Outreach CPTs
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) ​
Synonyms/Keywords
Hypercoagulability, Thrombophilia, PROTSI, PROT-CF, PTG, ATIII, FVL
Test Components
​Antithrombin III, Functional (ATIII), Protein C Activity (PROT-CF), Free Protein S Antigen, Factor V Leiden Mutation (FVL), Prothrombin Gene Mutation (PTG). 
Ordering Applications
Ordering Application Description
​Centricity ​Congenital Thrombotic Risk Pnl
​Cerner ​Congenital Thrombotic Risk Panel
​COM ​Congenital Thrombotic Risk Panel
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)
​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
​ 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 (-70) ​6 Months
Rejection Criteria
Clotted or Hemolyzed
​Contamination with IV or Hickman Line fluids
​Specimens that thaw during storage or transport
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.
Test Components
​Antithrombin III, Functional (ATIII), Protein C Activity (PROT-CF), Free Protein S Antigen, Factor V Leiden Mutation (FVL), Prothrombin Gene Mutation (PTG). 
Reference Range Information
Performing Location Reference Range
​Marshfield ​See individual test listings for reference ranges.
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ ​ ​ ​ ​ ​ ​ ​ ​ ATIII: Monday - Friday Less than 2 hours​ Chromogenic/Siemens CS 2500
PROTCF: Weekly 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: Tuesday and Friday​ 2-4 hours​ Liatest/IL ACL TOP 550
PROT-CI: Weekly​ 2-4 hours​ Liatest/IL ACL TOP 550
For billing questions, see Contacts
Outreach CPTs
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) ​
For most current information refer to the Marshfield Laboratory online reference manual.