Irradiation/Universal irradiation

[bmarotto]

We are evaluating our irradiation policy and would like to know what other places do. I would appreciate answers to any of these questions if they pertain to your facility:

1. Do you provide irradiated red cell/platelet products for all acute leukemias?

2. Do you provide irradiated red cell/platelet products for myelodysplastic syndrome?

3. If you provide all irradiated red cell/platelet products, how did you set up your fee structure? Do you charge all products the fee you used for non irradiated products, the fee for irradiated products, or did you establish a new fee somewhere in between?

4. If you provide all irradiated red cell/platelet products, did your compliance department have any concerns abou this?

Thanks in advance.

Bev

[Deny Morlino]

Bev,

We provide irradiated red cells/platelets upon physician request. If the patient is one we have historically administered these products to, we will double check with the ordering physician if irradiation has NOT been ordered. Our usual use of these products is in transplant patients, but we occasionally see orders for use in other patient diagnoses. We charge for the irradiated units only when administered per physician order. Hope this helps.

[DOGLOVER]

We use all irradiated apheresis platelet products. We did this for better inventory control and to eliminate risk of someone grabbing a non-irradiated unit inappropriately. We charge the cost for the irradiated products. We got medical staff approval so that all platelets are considered to be ordered as irradiated. Red cells; we keep 2 separate inventories. I would like to have all irradiated, but financially I can't get it done.

[L106]

Irradiated products upon physician request.

[SMILLER]

Same as Denny, above. Irradiated products most commonly used for chemo and other immunocomprimised patients at our facilities. Usually use our own cancer treatment center for irradiation.

As far as I know, we have not had any issues with charging for this, but then again, we always have a physician's order documented somewhere.

Scott

[Mabel Adams]

Remember that most inpatients are billed under DRGs so if you provide something that is higher cost, you are not getting reimbursed more for it. Sometimes the higher cost treatment is still justified, sometimes not. Outpatient charges to Medicare/Medicaid patients get reimbursed quite a bit lower than we charge so might be worth knowing what that reimbursement rate is and how it compares to the cost of providing irradiated products.

[Cliff]

We provide irradiated products for everyone. I can't speak to the billing part, but for us it was a patient safety issue. We are affiliated with a large cancer center, and rarely those patients would not have been registered at the main facility and would show up in our EW without restrictions. As I mentioned I am not aware of the billing issues; however, I do know it was investigated. We are a very large facility and transfuse a lot of products.