Our blood bank only offers irradiated blood products, and when we get an order not specifying 'irradiated', we credit the irradiation fee. But since we offer only irradiated blood, do we need to be doing this?

If you get a policy substitution policy approved by the medical staff executive committee, you do not need to credit the irradiation fee. Much the same as pharmacy substitution policies.

Thank you, I appreciate your idea. I was asked today if 'irradiated blood products' means that all blood products we offer had to be irradiated--Is that what you're saying as well?

No, I am saying that you define what you want as the substitution product if at all. For example, you may want to state that all orders for pack rbc's, leukoreduced rbc's, and platelet pheresis will be filled with irradiated products; and all frozen products will not be irradiated. THIS IS ONLY AN EXAMPLE. The point is to define exactly what you want as the product you want to give.

That makes sense. I'll run this idea by our medical director. Thanks, again!

We've drawn up a substitution policy stating that all orders for blood platelets will be filled with irradiated blood platelets. The question is, do we continue to charge the irradiation fee that belongs to radiology if the order does not specify 'irradiated'?

Yes, that is why you do the substitution policy. Since it is approved by Medical Staff Executive Committee, you can charge for it.

Include it in the cost, as you would the cost of pre-storage filtration. Otherwise, if you charge it separately you will get complaints that irradiation was not requested.

That was my thought as well, except it is a different department than Blood Bank (radiology) who will lose money. I suppose we could come up with a way to 'pay' them a lump sum each month...?

The blood component has code A, and the payment usually goes to the Blood Bank cost center. However, the office of the CFO and the Administration say that X $ of code A will go to the Blood Bank cost center and Y$ of the code A go to the Radiology cost center. So automatic distribution of collectables.

Sounds like all issues solved--good luck with it.

Actually, yes; you do need to credit. Just having a Medical Executive Committee state that is what they want, does not allow you to bill for this. I know because I recently checked into this exact issue! I have been at a new Hospital for about 2 1/2 months. It also gives only Irradiated RBCs (though I am planning to look into this again; due to the time involved in crediting patients not needing Irradiated; the money lost in giving Irradiated Products to so many patients who do not require it; the shortened shelf-life; etc). I spoke with some Blood Bank Billing Consultants in the country and was told that we could not charge patients who did not require it based on their diagnosis.

Brenda Hutson, MT(ASCP)SBB

Our blood bank only offers irradiated blood products, and when we get an order not specifying 'irradiated', we credit the irradiation fee. But since we offer only irradiated blood, do we need to be doing this?

Thank you, Brenda. This is the realization we've come to, as well. Due to system limitations, we have to have someone manually credit the fees and we were looking at all possible solutions to resolve this 'glitch' in the process. Ah, well. Better to do it correctly, though tediously than quickly and wrong!

And I am that "someone" who does the tedious work here....that is part of why I am going to change the Policy to only give IRR to patients who need it per their diagnosis (and for whom we can charge).

Brenda Hutson

Thank you, Brenda. This is the realization we've come to, as well. Due to system limitations, we have to have someone manually credit the fees and we were looking at all possible solutions to resolve this 'glitch' in the process. Ah, well. Better to do it correctly, though tediously than quickly and wrong!

Hi Brenda,

Why did the policy to give only irradiated products start?

JB

That was my question as well. Why that policy?