CPT® Code 85292

1. Indications

The prekallikrein assay (CPT® Code 85292) is indicated for the evaluation of patients who may have a bleeding disorder. The following conditions or symptoms may warrant the performance of this test:

• Abnormal Bleeding Time Test The assay is often performed when a patient exhibits an abnormal bleeding time test, particularly when the partial thromboplastin time (PTT or aPTT) is prolonged.
• Suspected Coagulation Disorders It is indicated in cases where there is a suspicion of a coagulation disorder that may involve the intrinsic pathway of the clotting cascade.
• Inherited Genetic Disorders The test may be utilized to diagnose inherited deficiencies of prekallikrein, which can lead to bleeding complications.
• Acquired Conditions It is also indicated in patients with acquired conditions such as liver disease, disseminated intravascular coagulation (DIC), or severe infections like sepsis, which may affect coagulation factors.

2. Procedure

The procedure for conducting the prekallikrein assay involves several key steps that ensure accurate measurement of prekallikrein activity. The following outlines the procedural steps:

• Step 1: Patient Preparation Prior to the test, the patient may need to be informed about the procedure, including any necessary preparations such as fasting or medication adjustments, although specific requirements are not detailed in the provided data.
• Step 2: Venipuncture A blood sample is obtained through a venipuncture, which is a procedure where a needle is inserted into a vein to collect blood. This step is crucial as the sample must be collected properly to avoid contamination and ensure accurate results.
• Step 3: Plasma Preparation After collection, the blood sample is processed to obtain platelet-poor plasma. This is typically done by centrifuging the blood sample to separate the plasma from the cellular components, ensuring that the assay measures only the clotting factors present in the plasma.
• Step 4: Clotting Activity Assay The prepared platelet-poor plasma is then subjected to a clotting activity assay specifically designed to measure the activity of prekallikrein. This assay evaluates the intrinsic pathway of the coagulation cascade, providing insights into the functionality of prekallikrein.

3. Post-Procedure

Post-procedure care for the prekallikrein assay primarily involves monitoring the patient for any immediate complications related to the venipuncture, such as bleeding or bruising at the site of blood collection. Patients are generally advised to resume normal activities unless otherwise directed by their healthcare provider. The results of the assay will be analyzed and interpreted by a qualified healthcare professional, who will discuss the findings with the patient and determine any necessary follow-up actions based on the results.