COAGULATION FACTOR XII ACTIVITY ASSAY PLASMA

General Information

HLAB/HOL Code: FAC12
UPHSM LIS Test #: 029990
Schedule:
Testing Time: 1-3 Days
Testing Lab: Mayo

Specimen Info
Only 1 specimen type required, unless otherwise specified

Volume: 1.0 mL
Temperature: Frozen
Tube Type: Platelet Poor Plasma (sodium citrate)
Collection Info:
Patient Preparation: Patient must not be receiving Coumadin or heparin therapy.
Collection Container/Tube: Light-blue top (citrate)
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL

Collection Instructions:
1. Specimen must be collected prior to factor replacement therapy
2. Centrifuge, transfer all plasma into a plastic vial, and centrifuge plasma again.
3. Aliquot plasma into a plastic vial, leaving 0.25 mL in the bottom of centrifuged vial.
4. Freeze plasma immediately (no longer than 4 hours after collection) at -20 degrees C or, ideally, < or =-40 degrees C.

Additional Information:
1. Double-centrifuged specimen is critical for accurate results as platelet contamination may cause spurious results.
2. Each coagulation assay requested should have its own vial.

Specimen Acceptability

REJECT DUE TO:
Gross hemolysis: Reject
Gross lipemia: Reject
Gross icterus: Reject

Methods

Optical Clot-Based

Clinical Utilities

Diagnosing deficiency of coagulation factor XII
Determining cause of prolonged activated partial thromboplastin time

CPT Codes

85280

* The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding
is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

Reference Range

Adults: 55-180%
Normal, full-term newborn infants or healthy premature infants may have decreased levels (> or =15-20%) which may not reach adult levels for > or =180 days postnatal.