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D-DIMER (089-0442)
Test Mnemonic:
Specimen Requirements:
Collection:

Blue-topped (3.2% sodium-citrate) tube. Routine venipuncture; discard 1st mL of blood by collecting a discard tube prior to collecting the blue-topped (3.2% sodium-citrate) tube.  For collections with butterfly blood collection sets, a discard tube should also be collected prior to collection of the blue top to ensure sufficient sample volume. Drawing a discard tube will displace the air from the blood collection set tubing to ensure proper blood draw volume.

Container:

Blue-topped (3.2% sodium-citrate) tube

Storage/Transport:

Separate the plasma from the cells and freeze at (-200C).

Specimen Preparation:

Centrifuge the specimen for 15 minutes at 2000-2500g.

Stability:

Whole blood 4 hours at room temperature.  Plasma storage: 8 hrs at 20 +/- 50C.  1 month at -200C. 

Causes for Rejection:

QNS, clotted, severely hemolyzed specimen, specimen greater than 4 hours old, wrong tube, high hematocrit (> 55%), sample identification error, sample processed/transported, and/or stored improperly.

Reference Range:

<0.41 ug/mL FEU

Galveston & Clear Lake Campus: < 0.5 ug/mL FEU

Turnaround Time:

STAT: 1 hour; ROUTINE: 4 hours

Methodology:

 Immuno-turbidimetric method, measured photo-optically at 540 nm. STA-Liatest D-dimer kit.

Performed:

 Accepted 24 hours/day at Sample Management, Room 7.412 CSW.

Clinical Indication:

Detects elevated levels of cross-linked fibrin derivatives associated with disseminated intravascular coagulation (DIC), deep vein thrombosis, pulmonary embolism and other thrombotic conditions.

This test may be used in conjunction with a clinical pretest probability (PTP) assessment model to exclude pulmonary embolism (PE) and as an aid in the diagnosis of deep venous thrombosis (DVT) in outpatients suspected of PE or DVT.

A D-Dimer value less than 0.50 ug/ml (FEU) has a negative predicative value of 98 to 100% (95% CI) for the exclusion of pulmonary embolism (PE) and 95 to 100% (95% CI) as an aid in the diagnosis of deep vein thrombosis (DVT) when there is low or moderate pretest probability of PE or DVT.

D-Dimer values are expressed in initial fibrinogen equivalent units (FEU).

CPT 4 Code:

85379

Note:

Interfering Substances: Rheumatoid factor, extremely high triglyceride level, lipemia, icterus, hemolysis.

 Increased levels of D-dimer have been reported in the post-operative period, cancers, hemorrhages, and severe infections. In various studies of STA-Liatest D-dimer kit, it has been reported that with a cut-off value of 0.50 ug/ml (FEU), the negative predictive value (NPV) regarding the exclusion of thrombosis (deep vein thrombosis or pulmonary embolisms) was within the 95-100% range

When ordering tests for which Medicare or Medicaid reimbursement will be sought, physicians should only order tests that are medically necessary for the diagnosis or treatment of the patient. Components of the organ or disease panels may be ordered individually. The diagnostic information must substantiate all tests ordered and must be in the form of an ICD-10 code or its verbal equivalent.
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