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DICP
DISSEMINATED INTRAVASCULAR COAGULATION (DIC) SCREEN, BLOOD AND PLASMA

Test Code DICP 
Test DISSEMINATED INTRAVASCULAR COAGULATION (DIC) SCREEN, BLOOD AND PLASMA 
Description D-Dimer (DDIME), Plasma
Fibrinogen (FIBRI), Plasma
Partial Thromboplastin Time (PTT), Plasma
Platelet Count, Blood
INR, Plasma
Reptilase Time (REPTI), Plasma (if indicated)
Smear Evaluation for Shistocytes, Blood
Thrombin Clotting Time (TCT), Plasma

Useful for the diagnosis of disseminated intravascular coagulation (DIC). Reptilase Time will be performed if indicated at an additional charge.

NOTE: This test, when ordered on Medicare patients, is subject to the National Coverage Determination (NCD) policies "Partial Thromboplastin Time (PTT)" and "Prothrombin Time (PT)". Please verify that the diagnosis code (ICD-9) you have chosen demonstrates medical necessity for the test as documented in the physician's patient record. The CMS web site or the NorDx Limited Coverage Documentation Guide are available to assist you with this verification. A properly executed Advance Beneficiary Notice (ABN) must be submitted with the specimen if medical necessity is not demonstrated by the ICD-9 code chosen. 

Specimen BOTH WHOLE BLOOD AND PLASMA ARE REQUIRED.

BLOOD
Draw blood in a lavender-top (EDTA) tube, (CLOTTED OR GROSSLY HEMOLYZED SPECIMEN IS NOT ACCEPTABLE.) and send 5.0 mL of EDTA whole blood at ambient temperature only.

PLASMA
Collect specimen as follows:
1. Draw blood in two light blue-top (3.2% sodium citrate) tubes. Separate plasma from cells within 1 hour of collection in a centrifuge at 2,500 rpm for 15 minutes or 3,000 rpm for 10 minutes.
2. Using a plastic transfer pipette (do not use a glass pipette) decant the plasma to a screw-capped, plastic (polypropylene) vial. (Glass vials will not be accepted.)
3. Divide the specimen into as many 0.5 - 1.0 mL aliquots as possible and cap the vial(s) tightly.
4. Freeze specimen(s) immediately at <= -40░ C.
5. Send specimen(s) FROZEN on dry ice.
NOTE:
1. SPECIMENS WILL BE REJECTED IF UNDERFILLED (< 90%), CLOTTED, HIGH HEMATOCRIT (> 55%), OR GROSSLY HEMOLYZED.
2. Follow "Special Procedure for Drawing Specimen from an A-line". 

Reference Values D-Dimer (XDPV), Plasma: <230 ng/mL DDU
Fibrinogen (FIBR), Plasma: 160 - 450 mg/dL
Partial Thromboplastin Time (PTT), Plasma: 24 - 36 seconds
Platelet Count, Blood: 140 - 400 x10^3/ÁL
INR, Plasma: 0.9 - 1.2
Reptilase Time (REPTI), Plasma: <14 / 21 seconds
Thrombin Clotting Time (TCT), Plasma: 11.0 - 15.0 seconds 
Analytic Time 1 Day - Available STAT 
Day(s) Test Set Up Monday through Sunday 
CPT Code(s) 85008  Smear
85049  Platelet count
85379  D-dimer
85384  Fibrinogen
85610  Prothrombin time
85635  Reptilase time, if indicated
85670  Thrombin clotting time
85730  Partial thromboplastin time

Special Instructions