Posted December 4, 201212 yr comment_47935 A type and cross for 2 units was ordered from the ED the other night for a 31 yr old female with no prior BB history. She was typed O Pos and a positive screen. She expired before antibody workup was completed. Doc called BB to cancel the order. Do we still have to complete the workup eventhough the patient expired already? Your feedback is greatly appreciated.
December 4, 201212 yr comment_47937 If you do finish the testing it will be for purely academic reasons and you should not bill anyone for it. That's my 2 cents worth.
December 4, 201212 yr comment_47941 Agree with John, UNLESS, you have evidence that it may be a very rare antibody that might be worthwhile keeping as a reagent!!!!!!!!!!!!!!!!!!!!..............but you still can't bill I suspect.
December 4, 201212 yr comment_47943 Ditto..I for one would finish the work-up. I don't think my curiosity would let me quit but I would not bill the patient for any testing performed after he/she expired.
December 5, 201212 yr comment_47960 I do not know of any mandate forcing the completion, but I agree with the other opinions... I would want to know the identity, but billing should not occur.
December 5, 201212 yr comment_47979 By all means finish, but chalk it up to a learning situation, you cant bill.
December 5, 201212 yr comment_47982 Everyone would bill for the original T&S right? That testing was complete and was a valid order at the time of testing. I agree that I would not charge for an ABID workup.
December 5, 201212 yr comment_47983 Yes bill for anything completed prior to the call informing the BB that the patient expired.
December 6, 201212 yr comment_47998 Yes bill for anything completed prior to the call informing the BB that the patient expired.Agree.
December 12, 201212 yr comment_48122 We generally finish the Type and Screen but then do not perform additional testing if the screen is positive. Our system does not charge for blood products until they are issued, so that billing problem is already solved.
May 18, 201312 yr comment_51071 Yes bill for anything completed prior to the call informing the BB that the patient expired.Agreed, and then, because we are a curious bunch, do our best to identify the antibody(ies).
May 20, 201312 yr comment_51087 IF she had received any blood I would have completed the work up. Lawyers are a funny group, even if the death had nothing to do with transfusion. If no blood received I would save the specimen (plasma/serum) for a student if you have any.
May 21, 201312 yr comment_51098 IF she had received any blood I would have completed the work up. Lawyers are a funny group, even if the death had nothing to do with transfusion. If no blood received I would save the specimen (plasma/serum) for a student if you have any. Agreed.
June 10, 201312 yr comment_51337 IF she had received any blood I would have completed the work up. Lawyers are a funny group, even if the death had nothing to do with transfusion. If no blood received I would save the specimen (plasma/serum) for a student if you have any. I agree with tricore. If the patient hasn't received blood, I agree with all others who said they would not charge for the Antibody Identification (even if they completed it to satisfy their curiosity.)
June 13, 201312 yr comment_51382 I would find it hard to justify the use of resources just for my curiosity but if you have the resources, go for it. Â I agree with Michelle's point if it had been transfused.
June 18, 201312 yr comment_51454 Who exactly are you going to charge for the type and screen? I didn't think there were any banks in Heaven (or wherever else you think people go after death)
June 18, 201312 yr comment_51455 Who exactly are you going to charge for the type and screen? I didn't think there were any banks in Heaven (or wherever else you think people go after death) Insurance companies, govt. agencies and family generally are still available even when the patient moves on.Â
June 19, 201312 yr comment_51477 Because we do not know the potential use in the future of any information we generate and because there would be know additional specimens collected, and because the specimen we do have is perishable I would lean towards completion of any testing to the extent of the blood bank performing the testing.
June 24, 201312 yr comment_51541 I agree with all you other posters here. No point in doing any more testing if the patient is not going to be transfused.  Our policy would be to not even do antibody ID testing for "academic" reasons. If its not going to be reported (it was cancelled!) we are not going to do the testing. There might even be a HIPPA (U.S.) or something violation in there otherwise. Scott
June 25, 201312 yr comment_51556 since the reagents and materials are already "in use" and that money is spent then i would finish the I.D. but it's not billable.  we apply something of a "finish-what-you-started" rule....i have seen a couple of dead patients start breathing again. Edited June 25, 201312 yr by BrianD
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