We've started getting requests for LARGE volumes of plasma for therapeutic plasma exchanges on adults and we currently do not have the ability to pool this in our computer system.  I've searched the ICCBBA database and cannot find an appropriate E code for the pooled product to build this in our computer system.  Does anyone pool plasma and if so, what E code are you using for the pooled product code?

We do not pool plasma for exchanges, just issue the 12 or 13 units or whatever in a cooler.

Just curious, what size bag are you thinking of pooling these in?  

Scott

We have pooled plasma for many years. Our computer was fine as long as we had Coda-bar numbers. ISBT has been a horrible problem. The therapeutic apheresis operators really really want us to pool because it is so much easier on them while they are running the instrument and taking care of the patient. It is a total pain to us and takes a tech almost an hour to pool once the units are thawed. We get the night techs to thaw when we know we have a patient the next morning. We have pooled as much as 7000ml each day for days on end. Ugg! We use 1000 and 2000ml transfer bags.

We have to do it in two steps, 1) thaw but don't print an ISBT label at this point, 2) pool and then print the pool label. Our computer is built to only thaw CPD units but the blood center sends us other Ecodes which throws a monkey wrench in the whole process. We ask them not to send us anything but CPD when we are dealing with pooling but you know how that goes.

We recently got this built in our system and these are the codes we have used:

Pool FPCR TH CPD makes FPCR TH CPD P E5304  (cryo-reduced)

Pool TH PLAS CPD makes TH PLAS CPD P E5275

Good luck

We have also been pooling plasma for apheresis procedures for years. At times we have had  3 patients at once. When they are all O Pos it is hard to get enough plasma. When we thaw the plasma the system automatically prints a label.

 

We use

E6371 Thawed POOLED PLASMA|NS/XX/refg|Open

Anticoagulant is Not Specified for this product as it is frequently a mix

 

We also have in case we ever pool this again:

E4992 POOLED PLASMA|CPD/XX/refg|Open|Cryo reduced

One of our sites was cited by FDA for pooling plasma with different anticoagulants. Therefore, we do not do it. Only like pools and several product codes in use.

You may want to ask FDA if pooling plasma with different anticoagulants is permissible.

On ‎5‎/‎12‎/‎2016 at 8:39 PM, butlermom said:

We've started getting requests for LARGE volumes of plasma for therapeutic plasma exchanges on adults and we currently do not have the ability to pool this in our computer system.  I've searched the ICCBBA database and cannot find an appropriate E code for the pooled product to build this in our computer system.  Does anyone pool plasma and if so, what E code are you using for the pooled product code?

What a good excuse not to pool the plasma.   Yes it is easy for the therapeutic operators but a pain for the blood bank.  Also, if for some reason, the exchange was cancelled or cut short, you would have a useless pooled product on your hands.    If the procedure was cut short, you have exposed your patient to many donors needlessly.  My 2 cents

On ‎5‎/‎13‎/‎2016 at 4:05 PM, R1R2 said:

What a good excuse not to pool the plasma.   Yes it is easy for the therapeutic operators but a pain for the blood bank.  Also, if for some reason, the exchange was cancelled or cut short, you would have a useless pooled product on your hands.    If the procedure was cut short, you have exposed your patient to many donors needlessly.  My 2 cents

Concur.

since the ecodes are different for the different anti-coagulants I do not believe they can be pooled as there would be no suitable label.  I agree with the others, keep away from pooling.  It also adds standards that you will then need to meet.

Do you have to be registered with the FDA to pool plasma? To pool single cryo?

I would think the answer is no since a new product is not created just like products put together.

As an update we now have 1,000ml and 2,000ml transfer bags for pooling plasma and we have built several pools based on anticoagulant in our computer system.  The FDA does not recommend pooling plasma with different anticoagulants, therefore, we are only pooling plasmas that are the same anticoagulant. The process is going smoothly except for the billing.  I have to e-mail my billing person with the patient's information and the number of plasma units we used so she can manually post the charges.  The only CPT code I can find is for solvent and detergent treated pooled plasma.  I'm thinking of just creating another orderable (we have Cerner Millineum) that we could use to submit the charges--something like "pooled plasma X 4" that has a specific charge since this would usually be the minimum number of plasmas pooled into the 1,000ml transfer bag. We could then just order it however many times needed for larger quantities.

Wouldn't you simply charge a pool CPT code for each pooled product and another charge for each unit of plasma?

We do just as Goodchild states.  Our computer system (Meditech) reflexes the pool charge each time one is issued and bills for each unit in the pool.