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Thromboplastin time, partial (PTT); substitution, plasma fractions, each

CPT4 code

Name of the Procedure:

Thromboplastin Time, Partial (PTT); Substitution, Plasma Fractions, Each

Summary

Partial Thromboplastin Time (PTT) is a blood test that measures how long it takes for blood to clot. This specific procedure involves substituting plasma fractions to assess and diagnose blood clotting disorders.

Purpose

The purpose of the PTT substitution test is to identify deficiencies or inhibitors in the clotting factors of the blood. This helps diagnose bleeding disorders, monitor the efficacy of anticoagulant therapy, and guide treatment plans for patients with abnormal clotting profiles.

Indications

This procedure is indicated for patients who:

  • Exhibit unexplained bleeding or bruising
  • Have a family history of bleeding disorders
  • Are undergoing evaluation for abnormal clotting test results
  • Are on anticoagulant medications (like heparin) requiring monitoring

Preparation

  • No special fasting is usually required.
  • Patients should inform their healthcare provider of all medications and supplements they are taking.
  • Some medications might need to be adjusted before the test.

Procedure Description

  1. A blood sample is drawn from the patient, usually from a vein in the arm.
  2. The sample is treated with reagents that require substitution with specific plasma fractions.
  3. Clotting time is measured in a laboratory setting using specialized equipment.
  4. The substitution of plasma fractions helps pinpoint specific deficiencies or inhibitors in the clotting cascade.

Duration

The blood draw takes about 5-10 minutes, while laboratory analysis can take a few hours to a few days depending on the complexity of the tests.

Setting

The blood sample is typically drawn in an outpatient clinic or hospital setting, and the analysis is performed in a specialized laboratory.

Personnel

  • Phlebotomist or nurse for blood draw
  • Laboratory technicians and pathologists for sample analysis

Risks and Complications

  • Mild pain or bruising at the blood draw site
  • Rarely, fainting or hematoma formation
  • No significant risks associated with the test itself

Benefits

  • Accurate diagnosis of clotting disorders
  • Effective monitoring of anticoagulant therapy
  • Helps guide appropriate treatment and management plans
  • Results are usually available within a few days

Recovery

  • Minimal recovery needed following the blood draw
  • Patients can resume normal activities immediately
  • Follow-up appointments may be required to discuss test results and treatment plans

Alternatives

  • Prothrombin Time (PT) test
  • Thrombin Time (TT) test
  • Specific clotting factor assays Each alternative has its specific applications and limitations, and the best choice depends on the clinical context.

Patient Experience

During the procedure:

  • Patients may feel a slight prick or discomfort during the blood draw.
  • Mild pressure may be applied to the site to prevent bleeding. After the procedure:
  • A small bandage will be applied, and patients can remove this after a few hours.
  • Any discomfort is typically mild and short-lived.

Medical Policies and Guidelines for Thromboplastin time, partial (PTT); substitution, plasma fractions, each

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