Test Code DICSCR DIC Panel

Specimen Type

Blood

Container

Two light blue top tubes (3.2% sodium citrate) and one lavender top tube

Preferred Volume

9.4 mL

Offsite Collection Instructions

Whole blood sample must arrive in the laboratory within three hours of specimen collection.

If transport time exceeds three hours, follow centrifugation instructions:

Samples must be centrifuged at >1500 x g for 10 minutes at room temperature.
Carefully remove the plasma from the cells using a plastic transfer pipette avoiding the buffy coat.
Aliquot removed plasma into 2 plastic tubes containing a minimum of 500 uL of specimen in each tube.
The plasma samples must then be frozen at -20ºC.
Once solidly frozen, they must be shipped on dry ice. Samples that have thawed in transit will be rejected.

Note: For clients who do not have access to dry ice DO NOT freeze the specimen. Follow the centrifugation instructions and send fresh plasma or send whole blood sample. It now becomes vital that the specimen arrives in the lab within three hours of collection.

Do not centrifuge lavender tube for Platelet Count. Do Not Freeze.

Availability

24/7

Turnaround Time

4 hours

STAT Availability

Available

Test Methodology

Clotting, Latex Immunoassay, and Sysmex XE5000 (plate count)

Additional Information

All 3.2% sodium citrate light blue top tubes require a ratio of 9 parts blood to 1 part anticoagulant (example: a 3.0 mL tube requires 2.7 mL blood added to 0.3 mL of anticoagulant).

ISTH DIAGNOSTIC SCORING SYSTEM FOR DIC
Risk assessment: Does the patient have an underlying disorder known to be associated with overt DIC?
   • If yes, proceed
   • If not, do not use this algorithm
Order global coagulation tests (Platelet Count, D-Dimer, PT, Fibrinogen)
Score the test results:
   • Platelet Count (per uL): >100,000 = 0; 50,000-100,000 = 1; <50,000 = 2
   • Elevated D-Dimer (ug/mL FEU): <0.4 = 0, 0.4-4.0 = 2, >4.0 = 3
   • Prolongation (in seconds) of PT above upper limit of its normal reference range: <3.0 = 0, 3.0-6.0 = 1, >6.0 = 2
    • Fibrinogen level (mg/dL): >100 = 0, <100 = 1
Calculate score:
   • If score 5 or greater, compatible with overt DIC:
     Repeat score daily
   • If score less than 5, suggestive (not affirmative) for non-overt DIC: Repeat next 1–2 days

CPT Code

D-dimer: 85379

Fibrinogen: 85384

PT: 85610

Platelet Count: 85049

Fee Code

D-dimer: 30585379

Fibrinogen: 30585384

PT: 30585610

Platelet Count: 53449

Test Includes

D Dimer, PT, FIBB, Platelet Count and DIC Score

Reference Range

See individual tests

Critical Results