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Cord Blood Testing

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We only test cord bloods from Rh negative mothers. But we hold the cord blood on O pos moms in case the pediatrician wants it tested. Does anyone test these "held" specimens after the baby has been discharged? If so do you have patient identification issues? Many of our babies have a completely different last name after discharge. Do you bill under the inpatient account since that was when the specimen was collected?

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We cross reference the medical record number, which should never change even if the name does, and the date of birth. If those match, despite name change, we are good to go. Our system will also make name changes on babies retro active, so that if we look up smith, baby from last week it will show smith,jane today.

We do the testing as requested on the new visit, as we have been asked not to add to inpatient visits past three days past dishcharge if at all possible.

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We order a non-reportable test called cord blood recepit on all of our cord bloods which is resulted with the mother's full name and medical record number. This gives us positive ID tracking since the cord blood is labeled with mom's name, even if the baby's last name changes. We hold them for a minimum of 7 days. If a doctor wants a sample tested after dismissal, we reregister the baby and perform the testing.

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Last year, we modified our Cord Blood testing procedure to state that only ABO/Rh and Weak D if Rh negative would be performed on cord bloods from infants of O or Rh Negative mothers. DAT would only be performed if mother has clinically significant antibody or when requested by physician. We now have a pediatrician who wants DAT on all Rh positive infants of Rh negative mothers. What tests are your hosptials doing?

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18 minutes ago, Winter said:

Last year, we modified our Cord Blood testing procedure to state that only ABO/Rh and Weak D if Rh negative would be performed on cord bloods from infants of O or Rh Negative mothers. DAT would only be performed if mother has clinically significant antibody or when requested by physician. We now have a pediatrician who wants DAT on all Rh positive infants of Rh negative mothers. What tests are your hosptials doing?

Your new Pediatrician should treat on symptoms, rather than laboratory results, but order laboratory tests to prove the symptoms.  It would be a lot cheaper, and would also show that the "Pediatrician" actually deserves the title.

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We do a cord eval work up (ABO/Rh and DAT) on infants born to Rh neg, group O  mothers and mother's with clinically significant antibodies. We hold all cord for 14 days and determine ID my MR number if needed, which doesn't change. The DAT is only done within 24 or 48 hours.... I'm home and don't recall at the moment!

Liz

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17 hours ago, Winter said:

Last year, we modified our Cord Blood testing procedure to state that only ABO/Rh and Weak D if Rh negative would be performed on cord bloods from infants of O or Rh Negative mothers. DAT would only be performed if mother has clinically significant antibody or when requested by physician. We now have a pediatrician who wants DAT on all Rh positive infants of Rh negative mothers. What tests are your hosptials doing?

we do like Liz but always wanted to change to what you are doing.   There is a lot of literature out there that you could share with your pediatrician about recommended cord blood testing.   Maybe you need to get your pathologist involved.  

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We test cords all O moms and all RH negative moms. The billing first goes to the baby registration but is backed out automatically and billed to the mothers account at discharge

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We don't get a cord unless there is an order (typically only Rh neg moms or moms w/ clinically significant antibodies).  Occasionally a pediatrician will order on an O mom if she's had a previously affected infant.  If they are concerned with an increased bili later, and we didn't perform a cord, they just do a heel stick ABO/Rh/DAT.

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