From Molly Klima, University Hospitals of Cleveland: Hi George, we are in the process of bringing up the Instrumentation Laboratory Silica Clotting Time (SCT) assay and are struggling with the CPT code. Since there is no straightforward CPT for the assay our dilemma is as follows:
- 85730 Thromboplastin time, partial (PTT); plasma or whole blood
- 85732 Thromboplastin time, partial (PTT); plasma or whole blood substitution, plasma fractions, each
Thanks to colleague Ali Sadeghi-Khomami PhD for his heads-up announcing the International Society on Thrombosis and Haemostasis‘ World Thrombosis Day launch. World Thrombosis Day will be held annually on October 13, the birthday of Rudolph Virchow, 1821, who coined the terms embolism and thrombosis. See the ISTH World Thrombosis Day page for details.
Charlie Muller, Helen Hayes Hospital TW, posted a question on the Medlab list, paraphrased here with his permission. He is validating the Akers PIFA Heparin/PF4 rapid assay kit for heparin induced thrombocytopenia with thrombosis, and needs a good way to validate it in addition to using Akers’ panels. Charlie’s setting is an acute rehab specialty hospital where a very large majority of patients have been exposed to heparin in various surgical procedures. They consult with a pathologist from Columbia University Medical Center who has had several discussions with the medical staff about HIT being a clinical diagnosis, using Warkentin’s 4T, etc. The staff want a little extra guidance from a rapid lab test.
From Prof. Jeanne Isabel, Northern Illihois University, a long-time friend and colleague. Hi George, a colleague who works at a cancer center has a patient on hydrocortisone (not sure how much) and her prothrombin time and international normalized ratio (PT/INR) were elevated to 54 s/4.9. she is on Coumadin and last time her INR was in the therapeutic range. She did not have symptoms to correlate with the elevated results. would the hydrocortisone cause this? Thanks.
A second great question from our Rutgers graduate hemostasis course participants, this one from Brandy Gunsolus, Healthplex Family Clinic in Shreveport, LA, and Jene Shafer from Orange Regional Hospital, Middletown, NY. We are studying the new cell-based model of coagulation and they ask whether the storage lesion of platelet concentrates affects their ability to be activated in vivo upon administration. The cell-based model relies on collagen and thrombin-activated (COAT) platelets; they wonder if stored platelets are able to be activated as effectively as patient’s own platelets. I have found no studies examining this question.