Blood Coagulation

The blood coagulation tests measure your coagulation profile, including INR, APTT, platelets, and fibrinogen. It is a screening test for abnormal blood clotting that examines the factors most often associated with a bleeding problem. Order from Ulta Lab Tests today with confidential results available online in 24 to 48 hours.

Did you know that as many as 900,000 people suffer blood clots each year? Learn why blood coagulation tests are so important for overall health.   

Below the list of tests is a guide that explains and answers your questions on what you need to know about blood coagulation tests, along with information on blood coagulation disorders, signs, symptoms, and diagnosis.

Name Matches
PT-Screening test for deficiencies of plasma coagulation factors other than Factors VII and XIII. The test is also used to monitor patients on heparin therapy. PTT-Screening test for abnormalities of coagulation factors that are involved in the extrinsic pathway. Also used to monitor effects of Warfarin therapy and to study patients with hereditary and acquired clotting disorders.

Screening test for abnormalities of coagulation factors that are involved in the extrinsic pathway. Also used to monitor effects of Warfarin therapy and to study patients with hereditary and acquired clotting disorders.

Screening test for deficiencies of plasma coagulation factors other than Factors VII and XIII. The test is also used to monitor patients on heparin therapy.

A Complete Blood Count (CBC) Panel is used as a screening test for various disease states including anemia, leukemia, and inflammatory processes.

A CBC blood test includes the following biomarkers: WBC, RBC, Hemoglobin, Hematocrit, MCV, MCH, MCHC, RDW, Platelet count, Neutrophils, Lymphs, Monocytes, Eos, Basos, Neutrophils (Absolute), Lymphs (Absolute), Monocytes(Absolute), Eos (Absolute), Basos (Absolute), Immature Granulocytes, Immature Grans (Abs)

NOTE: Only measurable biomarkers will be reported.

Reflex Parameters for Manual Slide Review
  Less than  Greater Than 
WBC  1.5 x 10^3  30.0 x 10^3 
Hemoglobin  7.0 g/dL  19.0 g/dL 
Hematocrit  None  75%
Platelet  100 x 10^3  800 x 10^3 
MCV  70 fL  115 fL 
MCH  22 pg  37 pg 
MCHC  29 g/dL  36.5 g/dL 
RBC  None  8.00 x 10^6 
RDW  None  21.5
Relative Neutrophil %  1% or ABNC <500  None 
Relative Lymphocyte %  1% 70%
Relative Monocyte %  None  25%
Eosinophil  None  35%
Basophil  None  3.50%
Platelet  <75 with no flags,
>100 and <130 with platelet clump flag present,
Instrument Flags Variant lymphs, blasts,
immature neutrophils,  nRBC’s, abnormal platelets,
giant platelets, potential interference
The automated differential averages 6000+ cells. If none of the above parameters are met, the results are released without manual review.
CBC Reflex Pathway

Step 1 - The slide review is performed by qualified Laboratory staff and includes:

  • Confirmation of differential percentages
  • WBC and platelet estimates, when needed
  • Full review of RBC morphology
  • Comments for toxic changes, RBC inclusions, abnormal lymphs, and other
  • significant findings
  • If the differential percentages agree with the automated counts and no abnormal cells are seen, the automated differential is reported with appropriate comments

Step 2 - The slide review is performed by qualified Laboratory staff and includes: If any of the following are seen on the slide review, Laboratory staff will perform a manual differential:

  • Immature, abnormal, or toxic cells
  • nRBC’s
  • Disagreement with automated differential
  • Atypical/abnormal RBC morphology
  • Any RBC inclusions

Step 3 If any of the following are seen on the manual differential, a Pathologist will review the slide:

  • WBC<1,500 with abnormal cells noted
  • Blasts/immature cells, hairy cell lymphs, or megakaryocytes
  • New abnormal lymphocytes or monocytes
  • Variant or atypical lymphs >15%
  • Blood parasites
  • RBC morphology with 3+ spherocytes, RBC inclusions, suspect Hgb-C,
  • crystals, Pappenheimer bodies or bizarre morphology
  • nRBC’s

Platelets must be present in adequate numbers and have proper function to aid in hemostasis.

Before ordering this test consider The Complete Blood Count (CBC) with Differential and Platelets Blood Test (Test # 6399) which is a better value.

In Quest's internal studies of more than two thousand patient samples, no significant abnormalities were detected with manual differentials associated with test code 20253 that were not otherwise identified thru the test code 6399 CBC Reflex cascade.

This test is a CBC reflex test and it will include the components of the CBC (Includes Diff/PLT) with Smear Review based upon the test results of the following analytes if are above or below ranges as outlined in the test.

  • WBC 
  • Hemoglobin 
  • Hematocrit 
  • Platelet 
  • MCV 
  • MCH 
  • MCHC 
  • RBC 
  • RDW 
  • Relative Neutrophil % 
  • Relative Lymphocyte % 
  • Relative Monocyte % 
  • Eosinophil 
  • Basophil 
  • Platelet 

Antinuclear antibodies are associated with rheumatic diseases including Systemic Lupus Erythematous (SLE), mixed connective tissue disease, Sjogren's syndrome, scleroderma, polymyositis, CREST syndrome, and neurologic SLE. 

Reflex Information: If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge.

Folic acid deficiency is common in pregnant women, alcoholics, patients with diets that do not include raw fruits and vegetables, and people with structural damage to the small intestine. The most reliable and direct method of diagnosing folate deficiency is the determination of folate levels in both erythrocytes and serum. Low folic acid levels, however, can also be the result of a primary Vitamin B12 deficiency that decreases the ability of cells to take up folic acid. Vitamin B12 is decreased in pernicious anemia, total


Hepatitis A Antibody, Total; Hepatitis B Surface Antibody, Qualitative; Hepatitis B Surface Antigen with Reflex Confirmation; Hepatitis B Core Antibody, Total; Hepatitis C Antibody with Reflex to HCV, RNA, Quantitative, Real-Time PCR

Hepatitis B Surface Antigen with Reflex Confirmation: Positive samples will be confirmed based on the manufacturer's FDA approved recommendations at an additional charge (CPT code(s): 87341).

If Hepatitis C Antibody is reactive, Hepatitis C Viral RNA, Quantitative, Real-Time PCR will be performed at an additional charge (CPT code(s): 87522).

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Vitamin K is a required co-factor for the synthesis of factors 2, 7, 9, and 10 and proteins C and S. Deficiencies of vitamin K lead to bleeding. Coumadin® (warfarin) acts as an anticoagulant because it is a vitamin K antagonist

C4B is a complement binding protein that specifically binds 50% circulating protein S, a vitamin K dependent cofactor of protein C activation. Since C4B may be elevated in certain disease states, this may affect the available "free protein S" to engage in anticoagulant activity.

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Serum calcium is involved in the regulation of neuromuscular and enzyme activity, bone metabolism and blood coagulation. Calcium blood levels are controlled by a complex interaction of parathyroid hormone, vitamin D, calcitonin and adrenal cortical steroids. Calcium measurements are useful in the diagnosis of parathyroid disease, some bone disorders and chronic renal disease. A low level of calcium may result in tetany.

Screening test to aid in diagnosis of disseminated intravascular coagulation (DIC) and acute occlusive vascular disease.

Lupus anticoagulants (LA) are members of a family of antibodies with phospholipid specificity. LA may be defined as an immunoglobulin, IgG or IgM or a mixture of both, that interferes with one or more of the in vitro phospholipid (PL) dependent tests of coagulation. These antibodies are not associated with a hemorrhagic diathesis, but rather have been linked to thrombotic events. In addition to thrombosis other clinical complications have been associated with the presence of LA. These include strokes, nonbacterial thrombotic endocarditis, livedo reticularis and a variety of obstetrical complications such as intrauterine fetal death, recurrent spontaneous abortion, fetal growth retardation, early onset preeclampsia and chorea gravidarum.

False elevations of potassium may be due to hemolysis or rupture of platelets during coagulation process. The use of plasma potassium levels should be limited to those patients with spuriously elevated or depressed potassium levels due to blood samples left at room temperature, in patients with chronic lymphocytic leukemia with very high WBC counts (false decline), and those with thrombocytosis (increased platelets) with counts in excess of one million (false elevation).

Aids in diagnosis of decreased activity of Protein C characterized by recurrent venous thrombosis. Acquired deficiencies associated with Protein C include: oral anticoagulant therapy, liver disease, vitamin K deficiency, malignancy, consumptive DIC, surgery, trauma, antibodies to Protein C and hepatic immaturity of the newborn.

Comprehensive test assesses the total level of protein and its functional activity in determining Protein C deficiency, which is strongly prothrombotic, and may require long-term anticoagulation therapy. In the presence of low Protein C Activity, Protein C Antigen helps to confirm and to classify Protein C Deficiency as Type I or Type II. Protein C is a highly thrombophilic protein.

In the presence of low Protein C Activity, Protein C Antigen is useful in classifying the deficiency as Type I or II.

Aids in diagnosis of congenital deficiencies characterized by recurrent venous thrombosis. Acquired deficiencies associated with Protein C include: oral anticoagulant therapy, liver disease, vitamin K deficiency, malignancy, consumptive DIC, surgery, trauma, antibodies to Protein C and hepatic immaturity of the newborn.

In the United States, 100,000 people die due to blood clots annually. In addition to that, 900,000 people end up dealing with venous thromboembolism every year. These numbers are so high because these blood clots are not caught in time to get taken care of before it becomes a serious problem.

Continue reading to learn more about clotting disorders and blood coagulation tests. 

What Are Clotting Disorders?

The body has a natural blood clotting process known as hemostasis. The body forces the injured blood vessel to constrict, and then platelets are sent to the injury site. They attach to the wound, and coagulation occurs. 

In clotting disorders, excessive clotting takes place. This is also known as a hypercoagulable state. This allows large blood clots to form where they shouldn't: in the bloodstream. These blood clots make their way to the legs (venous thromboembolism), the lungs (pulmonary embolism), and even the arteries of the heart (arterial thrombosis), and they block off blood vessels.

Clotting Disorders Causes

In some cases, it is acquired via underlying health conditions. These conditions might include:

  • Prolonged immobilization or bed rest
  • Autoimmune disorders (like Lupus)
  • Cancer or malignant tumor growth
  • Catheter use
  • Pregnancy or childbirth
  • Medical drug use (Hormone Replacement Therapy, oral contraceptives, or Heparin)
  • Cholesterol or calcium buildup in the bloodstream
  • Blood vessel inflammation
  • Heart failure
  • Obesity

It can also be an inherited health condition through genetic mutations, such as:

  • Factor V Leiden mutation
  • Prothrombin 20210 mutation
  • MTHFR mutation

It can be an inherited health condition due to:

  • Antithrombin
  • Protein C and S
  • Elevated Factor VII levels

Catching these blood clots early makes all of the difference between life or death in these patients. Knowing the signs can help in diagnosing these blood clots in time to seek treatment. 

Signs and Symptoms of Clotting Disorders

The different signs and symptoms of blood clotting disorders depend on the location of the blood clot. If the clot is in the leg, the symptoms include:

  • Leg pain or tenderness
  • Edema or swelling
  • Discoloration in the leg

If the clot is in the lung, the symptoms might include:

  • Sudden shortness of breath
  • Chest pain
  • Coughing up blood
  • Irregular heartbeat 
  • Fainting or lightheadedness
  • Anxiety

In other areas of the body, blood clot symptoms may mimic a heart attack or a stroke. If you find that you have any of these symptoms, you should speak with your doctor as soon as possible. 

There are certain tests that you can do to check for clotting disorders, so it's a good idea to be proactive if you notice you may have any of the risk factors associated with blood clotting disorders or you have any of the symptoms. 

Clotting Disorder FAQs

Should those with clotting disorders see a specialist? Your primary care physician can care for clotting disorders. However, when you have an active blood clot, you should make sure to see your hematologist to get it taken care of. 

If you are diagnosed with a clotting disorder, should your family members also get tested? Some of these conditions can be genetic. It is always a good idea for your family members to be tested for this disorder.

Who can have a blood clotting disorder? Men and women alike can have a clotting disorder. People of any age can develop a clotting disorder. They are more commonly diagnosed, however, among older teens and adults as they go through the normal changes in their blood.

Why Order Blood Coagulation Tests?

Blood coagulation tests are essential in finding possible blood clots throughout your body as a result of a clotting disorder. The tests that check for blood clotting include:

  • Prothrombin Time (PT)
  • Activated Partial Thromboplastin Time (aPTT)

The Prothrombin Time (PT) test monitors how fast the blood clots. The Activated Partial Thromboplastin Time (aPTT) test monitors how long it takes for the blood to clot.

At Ulta Lab Tests, we also offer a:

  • Complete Blood Count test
  • Fibrinogen level test

The Complete Blood Count test will look for signs of anemia or a low platelet count, which can cause abnormal blood clotting. The Fibrinogen test monitors your fibrinogen level (a protein found in the liver). It looks for abnormalities that point to excessive bleeding problems. 

A phlebotomist performs these tests: they are not at-home test kits! We offer these tests at affordable pricing, and you don't need a referral or insurance to get this testing done. These tests also come with a 100% satisfaction guarantee. 

Tests Needed to Confirm Low Platelet Counts

A low platelet count can be diagnosed, evaluated, and monitored through various blood tests. None of these tests can identify the cause of the low platelet count, but they can be used to identify the right treatment. These include the following:

  • Complete Blood Count – It is used to check the current platelet count and to identify if the bleeding has caused anemia (low hemoglobin levels).
  • Platelet Count – Checks the number of platelets in the blood, and it is part of the CBC test.
  • Blood Smear – It is done using a microscope to check the blood cells, including platelets.
  • Prothrombin Time and Partial Thromboplastin Time – It is used to check the clotting factors for proper clotting.
  • Basic Metabolic Panel or Comprehensive Metabolic Panel – Checks the overall health of your kidneys, liver, and other organs in your body.
  • Bone Marrow Aspiration and Biopsy – Checks cell production in the bone marrow if you have a low platelet count.
  • Heparin-induced Thrombocytopenia – Checks the antibodies against heparin and diagnoses thrombocytopenia. You can get this test if you have undergone or are currently undergoing heparin therapy.
  • Antiphospholipid Antibodies – Used to diagnose an existing autoimmune disease such as antiphospholipid syndrome as the cause of the low platelet count or its association with your platelets.
  • Antinuclear Antibody (ANA) – Used to diagnose an underlying autoimmune disease such as Lupus and its association or cause of low platelets.
  • Vitamin B12 And Folate – Any deficiencies in these vitamins cause a low platelet count, anemia, and a low white blood cell count (known as leukopenia).
  • Hepatitis B, C, and HIV – These are viral infections often associated with low platelets. If you have a low platelet count and test positive for these infections, they are the cause of the low platelet count.

Get Started Today!

If you are showing signs of a blood clot, it's important to talk to a health professional immediately. If you are worried that you might have a blood clotting disorder, blood clotting tests are available for purchase through our website. Once you have the results, you can go over them with your doctor and go from there.

Order your blood coagulation tests today, and you will get your results in 24 to 48 hours. A secure and confidential online server then sends results.