For those who have implemented performing a 2nd blood type on a new sample as a means of reducing the risk of ABO incompatible transfusion due to WBIT, do you charge for this 2nd blood type? I am setting it up not to charge unless I am assured it is allowed. I did a local poll and the results were mixed, but most do not charge.

We have second type on same sample but do not charge for it as it is consider a test which falls under QA.(not required).

We are the same as aakupaku. Our billing folks consider it part of compliance and not billable. We do not countn it as workload either.

We bill for it at one facility at which I work, but not the other hospital. It may be a local carrier thing ...

We don't charge for it; I don't believe it is chargeable.

I've been doing 2nd types since 1980 - never charged.

Thanks everyone. I am going to keep it as I have it set up (no charge).

We have been charging for over a year now. We only charge for the ABO. I don't have the exact documentation but there was something published saying we could begin to charge.

We don't charge for the retype.

Those who are billing for the second ABO might want to re-think that. Medicare does not allow billing unless you have demonstrated the test is medically necessary. They will simply deny the claim in the usual cases; but if you ever have a major problem with them, they will add these 'inappropriate' claims to their argument. We instituted second ABO in the early 90's, but have never charged for it.

We do not charge for the 2nd typing (foward), but we do count the workload.

I do not believe there is a code to bill for a re-type. We also perfrom a second confirmatory patient type, but do ot bill for this test.

I think you need to revisit this - since it is mandated by the CAP checklist to have a process to reduce risk, it does come under compliance and therefore is chargeable if that is your process.

We repeat the full ABO/Rh type using a specimen from a second stick whenever we do not have a history to compare and we charge. It is not just a quality control step, it is part of the required testing to provide compatible blood just like the antibody screen and the crossmatch.

When we began, we didn't charge because it was felt that the lab was doing this to increase revenue. But now, as it has become a standard of care, we do.

Ok, I got kind of lost with everyone's answers mainly because there was no clear indication if they were actually talking about "same tube-different Tech" second check or "new tube, different draw" second check.

If the AABB and CAP decide this should be protocol, then we should be able to charge for it eventhough we don't chart it because we do the work.

We currently do a same tube-different tech second check but I'm thinking we're going to have to change that.

This is a compliance issue. Just because your regulatory agency (which AABB and CAP are optional) requires it does not mean you are able to charge for it. You may have a problem because the physician didn't order it. How you may be able to get around this is what we do for reflex tests that we automatically perform without a doctor's order, such as adding an antibody ID whenever the antibody screen is positive:

We make a list of tests and send it to our Medical Executive Committee annually. All of the physician divisions are represented there, and they approve the list of tests. If they approve blood type verification as a patient safety initiative, and you have that documented, you could probably charge and not have to worry about fraud concerns later.

we do not charge for second ABO by second tech from same tube. Our compliance was not happy when we started charging in the beginning. We changed it to no charge test as this was not order by physician. I do not think our Med Ex will approve this as we are doing this to make sure the first type was correct.

Hi there!

Perhaps I was unclear about charges. We do not charge for the second check we do now. It is a "different tech-same draw" second check.

We do not charge for the 2nd ABORH.

We do not charge for second ABO.

We don't charge for the test, but do charge for the venipuncture.

Please pardon my ignorance, as I have a mental block with all the new acronyms being used these days, can someone tell me what is WBIT?

I'm new to the forum as well, but so far, it's been an enjoyable read for me.

WBIT is "wrong blood in tube".

LOL...makes perfect sense.

Thanks

We don't charge for the second ABO/Rh.