DATs and saline control

[skroc]

I work in a small hospital setting and currently when doind DATs we are not including a saline control. We are adding the Meditech BBK module and the lab manager would like to now include the saline control. Is there anyone else out there who is not including it? If we get a positive antibody screen we send it to our local Red Cross to be worked up.

Also, we are finally switching to IS crossmatches...does anyone have a procedure that I could take a look at?

Thanks!

[David Saikin]

Send me your email address to dsaikin@littletonhospital.org. I'll forward the ISXM policy.

[Mabel Adams]

At my prior lab we used to do a saline control only if the IgG and complement tests were both positive (otherwise the negative test served as a neg control). We had given up doing polyspecific first and just did IgG and complement on all adult DATs since the companies required purchase of such a large volume of poly AHG and we used it for nothing else. We used Meditech and had it built so it knew when to expect the control to be entered. I am sorry, I can't remember exactly how we did it. Here we do a saline control with all DAT tests but we aren't on Meditech.

[Lcsmrz]

You should use a cell control suitable to your AHG reagent. At our facility, it's 6% Alb for Anti-IgG and saline for Anti-C3,

[rescyth]

I use saline control only if i have a positive DAT

[Mabel Adams]

Larry,

Did the package inserts recommend those respective controls? Otherwise how did you choose alb for the AHG and saline for the complement?

[LESIZE]

At my prior lab we used to do a saline control only if the IgG and complement tests were both positive (otherwise the negative test served as a neg control). We had given up doing polyspecific first and just did IgG and complement on all adult DATs since the companies required purchase of such a large volume of poly AHG and we used it for nothing else. We used Meditech and had it built so it knew when to expect the control to be entered. I am sorry, I can't remember exactly how we did it. Here we do a saline control with all DAT tests but we aren't on Meditech.

We would like to eliminate performing Poly DAT, and do only IgG. How did you present this to your doc's. It certaintly would be cost saving.

Thanks,

[Yanxia]

Why not use auto serum add cells suspension be the negtive control instead of 6% Alb?

[Mabel Adams]

We just sent out a notice to the docs saying that when they ordered DAT they would get both results every time. That is required for the billing rules. The info they get from the test is no different: either the patient has no antibody/compl. on his cells, he has IgG, he has complement, or both. Whether you start with poly or not, they get the same info.

[bbbirder]

So, Mabel, are you billing both the IgG and C3 DATs?

Linda Frederick

[Mabel Adams]

Yes, we billed for "each antiserum" as the CPT codes dictate. Thus, in the past, pos patients ended up paying for 3 CPT codes, while negs paid for only one. Now everyone pays for 2. Since positives are not all that common, it probably costs the patients more as a group. Of course, since your costs are reduced and your reimbursement better, you could lower the price of them all to make it come out even.