how are people reporting their IS XM when it is paired with a gel crossmatch. In CErner Millenium we cannot order a IS XM and Gel XM on the same accession number and are you charging the patient for both tests?

Prior to the "new technologies" an ISXM was part of a Coombs' XM. I don't think you can bill for both.

Our crossmatch maintenance is built for phases IS, 37 degree, and AHG and CC. We enter reaction results for only the phases that we test and ND (not done) for the ones that we don't. This allows us to use the test XM for any type of testing performed. I believe that there are CPT codes for IS, 37 degree and AHG phases but I am not at work and can't check my CPT code book.

We actually have IS phase and AHG phase built into Coombs crossmatch test. We only assess one charge but cost per test takes into account cost of both phases.

I would strongly argue as to why this is necessary when our computer system has been validated for ABO comparison regardless of whether or not the patient has an antibody. Patient with an antibody would not qualify for electronic crossmatch, but it's still subject to the ABO logic tables at the time of selection and issue. I think we should really question the wisdom of FDA in requiring this since it makes NO sense at all!!!

Unfortunately, not all facilities have BBISs.

I would strongly argue as to why this is necessary when our computer system has been validated for ABO comparison regardless of whether or not the patient has an antibody. Patient with an antibody would not qualify for electronic crossmatch, but it's still subject to the ABO logic tables at the time of selection and issue. I think we should really question the wisdom of FDA in requiring this since it makes NO sense at all!!!

IS crossmatch tests ABO compatibility, Gel crossmatch tests any unexpected antibody in patient's plasma againsting donor red cells. They test different things.

CK Cheng, MSc, SBB(ASCP), CQA(ASQ)

Edited March 1, 201114 yr by ckcheng

I've known of places that validated gel for detecting ABO incompatibility. Is anyone doing this?

Ortho indicated in the FYI bulletin recently that some of their customers had been cited as out of compliance even when they had performed this validation process. In the question and answer section of the same bulletin the following was included:

3. Can I perform crossmatch validation with the MTS Anti-IgG Card to detect ABO incompatibility?

The answer given was: It is not recommended that you perform validation to detect ABO incompatibility with the MTS Anti-IgG Card as extensive variations and large numbers of ABO phenotype samples would be required.

I would love to see the IgG card use validated, but will wait for Ortho to do the work on this to stay away from the risk of compliance failure.

I think there are two ways to detect ABO incompatible. Electronic crossmatch - the fastest cuz take only seconds. Then immediate spin - take minutes.

CK Cheng, MSc, SBB(ASCP), CQA(ASQ)