AHA Coding Clinic® for HCPCS - 2010 Quarter 3; ASK the EDITOR
Dilute Russell's Viper Venom
Dilute Russell’s Viper Venom time (DVV) is a test we perform to test for lupus anticoagulation. Two distinct reagents exist for this test, a DVV test reagent (low phospholipid) and DVV confirm reagent (high phospholipid), if needed. The concentration of snake venom is the same in both as is the test set-up (one part patient plasma and one part reagent). The patient’s plasma is run with the DVV test (low phospholipid) reagent to determine the clotting time in seconds. The patient’s clotting time is divided by the normal control clotting time to attain a ratio. If the ratio is less than 1.3, the test is stopped – patient is “negative” (approximately 80% of our patient population). If the ratio is equal to or greater than 1.3 we repeat the test using the DVV confirm reagent (high phospholipid) to verify that the patient is truly “positive”. We divide the patient’s DVV test time by the patient’s DVV confirm time and if it is less than 1.3 ration then patient is “negative”, if above 1.3 the patient is “positive”. Approximately 20% of our population requires confirmatory testing. The test results indicate the initial test ratio, the confirmatory ratio as well as a final positive or negative result. When the confirmatory test is performed, is it appropriate to bill an additional unit of CPT code 85613 , Russell viper venom time (includes venom); diluted , for the confirmatory test performed with a different reagent? ...
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Article Overview
This article is a laboratory testing overview focused on Dilute Russell’s Viper Venom (DVV) testing in the context of lupus anticoagulation evaluation. It discusses the test setup, the use of screening and confirmatory reagents, and the general approach to comparing clotting times and ratios. The content is useful for laboratory billing, pathology, and coding professionals who need to understand the test’s structure and the type of reporting logic involved.
Why This Topic Matters
Understanding DVV testing helps coding and billing staff recognize how this laboratory assay is performed and documented, which supports accurate review of pathology-related laboratory services.
What You Will Learn
- What Dilute Russell’s Viper Venom testing is used for
- How the screening and confirmatory reagents differ at a general level
- How clotting-time comparisons are used in the testing workflow
- Which laboratory context the test is associated with
Who Should Read This
- Medical coders
- Billing staff
- Pathology laboratory staff
- Compliance reviewers
- Healthcare administrators
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