Hypercoagulation/Thrombophilia Tests No Longer Available for Adult Emergency Room (ED) and Inpatient

Effective 10/29/2025, hypercoagulation/thrombophilia test ordering will no longer be available in the adult inpatient and emergency department settings at Corewell Health West.

This change aligns the hospital system with the American Society of Hematology Choosing Wisely initiative. This will decrease unnecessary costly testing in the inpatient setting and help to prevent inappropriate diagnoses.

The following orders will be impacted by these changes:

• SH IP HYPERCOAGULATION WORKUP PANEL
• Protein C Activity [LAB489]
• Protein S Activity [LAB491]
• Lupus Screen [LAB478]
• Antiphospholipid Antibody Syndrome Panel [LAB1230572]
• Factor V Leiden DNA Analysis [LAB346]
• Prothrombin G20210A [LAB8340]
• Factor V Leiden DNA / Prothrombin G20210A [LAB1230857]

• “Hypercoagulable Testing, Adult, Inpatient” pathway patients with DVT or PE
• “Hypercoagulable Testing, Adult, Inpatient” for patients with ischemic stroke

For appropriate cases, the following tests remain available:

• Beta-2 glycoprotein I antibodies (LAB1231793)
• Cardiolipin Antibodies (LAB1231792)

Note: These pathways do not apply to pediatric patients or pediatric protocols.

Resources

• Choosing Wisely Ten Years on: Inpatient Thrombophilia Testing
• American Society of Hematology 2023 guidelines for management of venous thromboembolism: thrombophilia testing
• Choosing Wisely in Thrombophilia: Hematologist Required