Antibody Titers

[johna]

Do you automatically perform and report an antibody titer in the event that a prenatal patient presents with a clinically significant antibody?

OR

Do you require a physician's order before the titer will be done/reported ?

How about billing?

Is the titer included in the Antibody ID charge or is the titer billed separately?

Just curious as to how this is handled! Thanks!

[bbbirder]

Yes, we automatically perform the titer on prenatals with clinically significant Abs.

No, we don't get a separate physician order. (However, we do include this in the annual doctor letter about all reflex testing. Doctors on staff must sign this.)

We bill it separately.

Linda Frederick

[TOBYCAT]

We must have a Doctors order before we do a titer, but we send ours to our referance lab. We may only do 3 or 4 a year, but we do show our Medical Technology students how to do them.

[Cathy]

We do them automatically and the charge for the panel is included in the titer charge.

[Mary]

We freeze the specimen and suggest that the doctor send us an order for a titer. If you don't have an order, you will not get reimbursed. Sometimes they refer these patients to a lage metropolitan hospital and they follow the antibody. We charge seperately from the antibody ID.

[elrusso]

We do the titer automatically, but we have written permission from our MEC (Medical Executive Committee) to perform reflex testing in certain situations.

[Eagle Eye]

we do titer on all our OB patient for all antibody other than anti-D.

We recently stop doing titer on our OB patient if we have a history of RHIG.

[GilTphoto]

we do titer on all our OB patient for all antibody other than anti-D.

We recently stop doing titer on our OB patient if we have a history of RHIG.

Most of the time, when you get an anti-D on an OB patient, it's passively acquired due to antepartum RhIG,

BUT, if you get reactions in any other phase other than IAT, or get reactions stronger than 2+, you may be dealing with an active immune response, and a titer would be recommended. Passively acquired anti-D rarely has a titer > 1:4, or reacts in other phases other than IAT

We have had two mothers recently, who received antepartum RhIG, but the anti-D was reacting at IS and 37. Both babies had a positive DAT with anti-D eluted. One mother had a titer of 64, the other had a titer of 256. Her baby's cells typed Rh neg, due to large amounts of anti-D coating the cells. Neither baby required transfusion. Bilirubin went from 3.2 at birth, 6.5 day 1, 14.9 day 2, then started dropping.