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Coagulation time; activated

CPT4 code

Name of the Procedure:

Activated Coagulation Time (ACT)


Activated Coagulation Time (ACT) is a blood test that measures how long it takes for your blood to clot when certain activators are added. This helps evaluate the effectiveness of anticoagulant therapies and detect bleeding disorders.


Medical Conditions Addressed:

  • Monitoring anticoagulant therapy (especially during surgeries)
  • Diagnosing bleeding disorders

Goals/Expected Outcomes:

  • Ensure safe levels of anticoagulation during and after surgical procedures
  • Identify bleeding abnormalities for appropriate treatment


Symptoms/Conditions Warranting the Procedure:

  • Patients receiving anticoagulant medication (e.g., heparin)
  • Patients undergoing cardiac or vascular surgery
  • Suspected bleeding disorders
  • Patients with unexplained prolonged bleeding

Patient Criteria:

  • Individuals on heparin or other anticoagulants
  • Surgical patients requiring precise anticoagulant management


Pre-Procedure Instructions:

  • No specific fasting or preparation required
  • Inform the healthcare provider of all medications taken
  • Previous coagulation tests may need to be reviewed

Diagnostic Tests/Assessments:

  • Review of current anticoagulation therapy levels

Procedure Description

  1. A healthcare provider will clean the site of blood draw (typically the arm).
  2. A blood sample will be taken using a sterile needle.
  3. The blood is then placed in a test tube containing an activator substance.
  4. The test tube is inserted into a machine that times how long it takes for the blood to clot.


  • Sterile needle and syringe
  • Test tube with clotting activator
  • ACT machine


  • Not required


The procedure typically takes about 5-10 minutes.


  • Outpatient clinic
  • Hospital laboratory
  • Surgical center


  • Nurse
  • Phlebotomist
  • Lab technician

Risks and Complications

Common Risks:

  • Minimal risk from blood draw, such as slight pain or bruising at the site

Rare Risks:

  • Infection at the puncture site
  • Excessive bleeding

Possible Complications Management:

  • Keeping the puncture site clean and dry
  • Applying pressure to control bleeding


Expected Benefits:

  • Accurate monitoring of anticoagulant therapy
  • Improved safety during surgical procedures
  • Early detection and management of bleeding disorders

Timeframe for Realization:

  • Immediate results aid in real-time decisions during surgeries


Post-Procedure Care:

  • Apply pressure to the puncture site if instructed
  • Watch for signs of infection or excessive bleeding

Expected Recovery Time:

  • Immediate return to usual activities
  • No specific recovery period required


  • Follow-up tests may be required to monitor anticoagulation therapy


Other Treatment Options:

  • Prothrombin Time (PT) test
  • International Normalized Ratio (INR) test
  • Partial Thromboplastin Time (PTT) test

Pros and Cons compared to ACT:

  • PT/INR and PTT provide information on different aspects of blood clotting and may be used for different anticoagulants.

Patient Experience

During the Procedure:

  • Slight discomfort from the needle stick

After the Procedure:

  • Mild soreness or bruising at the blood draw site

Pain Management/Comfort Measures:

  • Use of ice packs to reduce bruising and discomfort
  • Over-the-counter pain relievers if necessary

Overall, the Activated Coagulation Time (ACT) test is a quick and essential procedure to ensure effective and safe anticoagulation therapy during critical medical procedures.

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