Centralized Core Laboratory - Cleveland Clinic Laboratories :
Send Out
PATIENT INFO
Patient Name:
Medical Record #:
BD: //Sex: F M
PHYSICIAN INFO
Physician Name :
Address:
Ph: ()-Fax: ()-
Additional Report to:
Ph: ()-Fax: ()-
TESTS REQUESTED
Test Name:
ICD9 Code: (required)
1. Circulating Anticoagulant Inhibitor
2.
3.
4.
5.
6.
SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
CAI
Test Workstation :
CLEVE
Specimen Type:
Blood
Tube Type:
Blue top (sodium citrate) tube
Collection Volume:
2.8 mL
Minimum Volume:
1.8 mL
Storage:
Strict Frozen
Availability:
Sent to reference lab
Methodology:
Clotting Assay
Special Instructions:
Discontinue coumadin therapy for 14 days and heparin therapy for 2 days prior to collection.
If collected at an offsite location, send by a STAT Courier to Hospital lab
OC Power Word:
Indicate Factor VIII or IX
Lab/Phone:
330-543-8418
TAT:
1-3 days
Additional Info:
Reference range: < or = 0.4 Inhib Unit
CPT Code:
85335
Synonyms:
Bethesda Inhibitor
Circulating Anticoagulant Inhibitor
Test ID/Workstation :
CAI
Specimen Type:
Blood
Tube Type:
Blue top (sodium citrate) tube
Collection Volume:
2.8 mL
Storage:
Strict Frozen
Availability:
Sent to reference lab
Methodology:
Clotting Assay
Special Instructions:
Discontinue coumadin therapy for 14 days and heparin therapy for 2 days prior to collection.
If collected at an offsite location, send by a STAT Courier to Hospital lab
OC Power Word:
Indicate Factor VIII or IX
Lab/Phone:
330-543-8418
TAT:
1-3 days
Additional Info:
Reference range: < or = 0.4 Inhib Unit
CPT Code:
85335
Synonyms:
Bethesda Inhibitor
By using this site, you consent to our use of cookies. To learn more, read our
privacy policy.