Vitalant Specialty Laboratories & Therapeutics


Effective 4/12/2021, the semi-quantitative D-Dimer will be replaced with a Quantitative D-Dimer test in our DIC Screen.  Our new panel is called DIC Screen 2 and the service code is 6376.  The CPT codes for the new panel are the same except code 85379 is replacing 85378.


Effective 3/26/2021, due to a nationwide shortage of reagents, we are unable to perform molecular testing for the Prothrombin Gene Variant and the MTHFR Gene Variant C677T.  This testing is discontinued until further notice. 

Test Request Instructions

Instructions for Completing the Coagulation Laboratory Test Requisition Form

  1. Complete a separate Test Requisition for each patient.
  2. Please use a pen to complete the form. Be sure to PRINT legibly.
  3. Record the Following
    • Your client account number or hospital name/address if not already there.
    • Patient name, patient ID (not SSN), date of birth, sex, lab ID number
    • Collection date/time
    • Ordering physician name
  4. Complete medication history area (if applicable). It is especially important to note any COUMADIN, HEPARIN, or direct thrombin inhibitors (such as Lepirudin or Argatroban) in use.
  5. Mark box(es) with an X or checkmark indicating the tests requested. If you wish to decline automatic reflexing of a test, you must mark the box provided for this purpose.
  6. If requesting the Heparin Level/anti Xa Assay, mark the type of heparin the patient is receiving. This information MUST be provided; otherwise the laboratory will run the assay as if the patient is receiving unfractionated heparin.
  7. Write the required patient information on the specimen container. Refer to Specimen Labeling Policy.
  8. Keep a copy of the requisition for your records. 
  9. Fold a copy of the requisition with the patient information facing out.
  10. Place the labeled specimen(s) in the ziplock portion of the specimen bag. Place the folded test requisition into the outside pocket of the specimen bag.
  11. If multiple transport temperatures are required, place specimen(s) in separate bags. Refer to the Shipping/Packing Instructions.