Posted August 23, 200618 yr comment_2891 Do you automatically perform and report an antibody titer in the event that a prenatal patient presents with a clinically significant antibody? ORDo 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!
August 23, 200618 yr comment_2892 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
August 23, 200618 yr comment_2893 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.
August 28, 200618 yr comment_2906 We do them automatically and the charge for the panel is included in the titer charge.
August 28, 200618 yr comment_2908 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.
September 7, 200618 yr comment_2960 We do the titer automatically, but we have written permission from our MEC (Medical Executive Committee) to perform reflex testing in certain situations.
September 7, 200618 yr comment_2964 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.
November 5, 200717 yr comment_6052 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.
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