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Clotting inhibitors or anticoagulants; protein S, free

CPT4 code

Name of the Procedure:

Clotting Inhibitors or Anticoagulants; Protein S, Free (Technical/Medical Term: Free Protein S Antigen Test)


A Free Protein S Antigen Test is a blood test that measures the level of Protein S in your blood. Protein S is a natural anticoagulant that helps prevent blood clots. This procedure helps determine if you have a deficiency in Protein S, which can increase the risk of developing abnormal blood clots.


Medical Condition or Problem Addressed:

The procedure is used to diagnose conditions that may increase the risk of forming blood clots, such as inherited thrombophilia.

Goals or Expected Outcomes:
  • To measure the level of free Protein S in the blood.
  • To help diagnose protein S deficiency.
  • To assess the risk of thrombotic events (blood clots).


Specific Symptoms or Conditions Warranting the Procedure:
  • Unexplained thrombotic events
  • Family history of blood clotting disorders
  • Repeated miscarriages or complications in pregnancy
Patient Criteria or Factors:
  • Individuals with a history of unexplained blood clots
  • Patients with a family history of protein S deficiency or other clotting disorders
  • Women with recurrent miscarriages


Pre-Procedure Instructions:
  • Patients may be advised to stop certain medications that can affect clotting, such as warfarin, before the test.
  • Fasting is generally not required for this test.
  • Inform your healthcare provider about any medications or supplements you are taking.
Diagnostic Tests or Assessments:
  • A complete medical history and physical examination might be conducted.
  • Other blood tests might be ordered to rule out different clotting issues.

Procedure Description

Step-by-Step Explanation:
  1. A healthcare provider will draw a blood sample from a vein, usually in your arm.
  2. The blood sample is sent to a lab for analysis to measure the level of free Protein S.
Tools, Equipment, or Technology Used:
  • Sterile needle and syringe or a vacuum tube system
  • Tourniquet
  • Blood collection tubes
Anesthesia or Sedation Details:
  • No anesthesia or sedation is required; it is a simple blood draw.


The blood draw itself typically takes less than 5 minutes. Results may be available in a few days, depending on the lab.


The procedure is performed in various settings:

  • Outpatient clinic
  • Hospital
  • Diagnostic laboratory


Healthcare Professionals Involved:
  • Phlebotomist or nurse (to draw blood)
  • Lab technician or pathologist (to analyze the blood sample)

Risks and Complications

Common Risks:
  • Minor bruising at the blood draw site
  • Mild discomfort or pain at the puncture site
Rare Risks:
  • Infection at the puncture site
  • Excessive bleeding
Possible Complications and Their Management:
  • Hematoma formation: applying pressure and cold compress can help
  • Infection: usually managed with antiseptics and rarely antibiotics


Expected Benefits:
  • Accurate diagnosis of Protein S deficiency.
  • Proper management and prevention of thrombotic events. ##### Timeframe to Realize Benefits:
  • Benefits can be realized shortly after receiving test results and having a tailored treatment plan.


Post-Procedure Care and Instructions:
  • No specific post-procedure care needed.
  • Keep the puncture site clean and dry.
Expected Recovery Time:
  • Immediate recovery; patients can resume normal activities right after the blood draw.
Restrictions or Follow-up Appointments:
  • No restrictions required. Follow-up appointments may be necessary to discuss test results and further management.


Other Treatment Options:
  • Other blood tests for clotting disorders, such as tests for Protein C, Antithrombin, or genetic testing for Factor V Leiden mutation.
Pros and Cons of Alternatives:
  • Alternative tests might provide more comprehensive information but may also involve additional costs and time.

Patient Experience

During the Procedure:
  • A brief sting or pinch when the needle is inserted.
  • Mild discomfort during the blood draw.
After the Procedure:
  • Minimal to no pain after the procedure.
  • Easy resumption of daily activities.
Pain Management and Comfort Measures:
  • Comfort measures include talking through the procedure and using distraction techniques.
  • Applying a cold compress if there’s minor swelling or bruising at the puncture site.

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