Test Code FVDNA FACTOR V LEIDEN MUTATION, BLOOD

Important Note

This test may require pre-authorization or have limited coverage. Please check with your appropriate insurance carrier to determine any specific requirements.

Additional Codes

Software	Test Code
Label Text	FVDNA
EPIC	LAB10246

Performing Laboratory

NorDx Laboratories

Useful For

Coagulation disorders and to determine Zygosity

Method Name

Polymerase Chain Reaction (PCR) with DNA probes

This assay is a lab developed test established by the NorDx Molecular Pathology Laboratory. This laboratory is certified under the Clinical Laboratory Improvement Amendments (CLIA) as qualified to perform high complexity clinical laboratory testing. This test is used for clinical purposes. It should not be regarded as investigational or for research.

Reference Values

Negative (reported as negative or positive with zygosity)

Days and Times Test Performed

Wednesday

Evenings

Report Available

1 Day

Specimen Type

Whole Blood

Preferred Container

Lavender Top Tube (EDTA)

Preferred Volume

Whole Blood: 4.0 mL (Lavender Top Tube (EDTA))

Minimum Volume

Whole Blood: 0.5 mL (Lavender Top Tube (EDTA))

Specimen Collection and Handling

1. Sample must arrive within 7 days of collection.

2. Send at ambient temperature or refrigerated.

Specimen Stability Information

Specimen Type: Whole Blood

Refrigerated: 7 Days

Room Temp: 7 Days

Add On Capable

Yes

Advance Beneficiary Notice Requirements

This test, when ordered on Medicare patients, is subject to the National Coverage Determination (NCD) policies. Please verify that the diagnosis code (ICD code) you have chosen demonstrates medical necessity for the test as documented in the physician’s patient record. The CMS web site is 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 code chosen.

CPT Code Information

CPT Code	CPT Description	CPT Disclaimer
81241	F5 (Coagulation Factor V) Gene Analysis, Leiden Variant

Keywords

FACTOR V LEIDEN

FV (FACTOR V)

FV (FACTOR V) GENE MUTATION

LEIDEN GENE

Performing Laboratory Location