Those of you who send out samples from weak D OB patients for molecular testing, do you know, approximately, how much the test costs and whether insurance companies willingly pay for it?  I am having trouble finding this information.  Thank you!  Catherine

I am working with our OB/GYN MDs on how we will handle weak D OB patients.  First of all, we would like to know how available the test is and how expensive it is.  When I contacted our IRL to inquire about the price of this test, which they list on their menu, I can only speak with technical people who know nothing about billing, and I do not expect them to--I am a technical person and I know nothing about billing. They did tell me they send the test to Grifols and they gave me a contact number which didn't work out. The very nice people at the other end of the line did not understand my question.  (My fault?).  Using the term "genotype" to describe the test sent them down the wrong rabbit holes--interesting but not helpful.  Today I called our IRL again and they gave me another number.  Nobody answered, but it is MLK day.

5 hours ago, cbaldwin said:

I am working with our OB/GYN MDs on how we will handle weak D OB patients.  First of all, we would like to know how available the test is and how expensive it is.  When I contacted our IRL to inquire about the price of this test, which they list on their menu, I can only speak with technical people who know nothing about billing, and I do not expect them to--I am a technical person and I know nothing about billing. They did tell me they send the test to Grifols and they gave me a contact number which didn't work out. The very nice people at the other end of the line did not understand my question.  (My fault?).  Using the term "genotype" to describe the test sent them down the wrong rabbit holes--interesting but not helpful.  Today I called our IRL again and they gave me another number.  Nobody answered, but it is MLK day.

Could I suggest the term "molecular Techniques", rather than "genotyping", as the two terms "(pheno)typing" and "(geno)typing" are, sadly, often confused, particularly by the "lay person" at the front of the office taking calls?  It might work/it might not!

Where are you located?  Our Immucor rep supplied us with a coding guide for reimbursement, and you can also send specimens directly to Immucor for testing.  We send ours through our Red Cross IRL.  At this time, the last information I received is that reimbursement is for a complete HEA Genotype only, Rh genotype for weak/ partial D is NOT reimbursed because only the complete genotype is FDA approved.  I reached out to our Immucor rep for more information if you are interested.

The companies are all supposed to offer the test for around $300 as I recall.  They are charging that much but then we can't charge any markup on the test if we are to keep it so that it is cost-effective for the patient relative to the cost of RhIG.  ARC National has it listed on their price list but, as those above said, they are doing only the full genotype now.

On 1/17/2017 at 6:32 AM, SBBSue said:

Where are you located?  Our Immucor rep supplied us with a coding guide for reimbursement, and you can also send specimens directly to Immucor for testing.  We send ours through our Red Cross IRL.  At this time, the last information I received is that reimbursement is for a complete HEA Genotype only, Rh genotype for weak/ partial D is NOT reimbursed because only the complete genotype is FDA approved.  I reached out to our Immucor rep for more information if you are interested.

Thank you! This is good information.  I will call our Immucor rep.  Catherine

Edited January 19, 20178 yr by cbaldwin
left out the verb "call"

On 1/17/2017 at 6:12 PM, Mabel Adams said:

The companies are all supposed to offer the test for around $300 as I recall.  They are charging that much but then we can't charge any markup on the test if we are to keep it so that it is cost-effective for the patient relative to the cost of RhIG.  ARC National has it listed on their price list but, as those above said, they are doing only the full genotype now.

Thank you for this information. 

I just found the handouts from a lecture Sue Johnson gave in March 2016 at an Immucor Users meeting and I have attached them in case anyone is interested.  It's very good.  She discusses the molecular basis of weak D and partial D and the variability of reagents and methodology, also the recent recommendations of the Inter-organizational Work Group on RHD genotyping for managing pregnant women and transfusion recipients who have a serologic weak D phenotype.

  On page 18 she states that there is a new CPT code 81403 for RHD genotyping (Tier 2 molecular pathology procedure, Level 4) and that reimbursement rates for the Tier 2 code are being established.  Also that the ACOG is updating its Practice Bulletin to recommend molecular testing.

I just got a new phone number to call to see if I can get the price that we will be charged if we request this test.  My OBGYN physicians would like to know.

Catherine

Johnson Handouts.pdf

Just found out...our reference lab charges $305.  Thanks all for your replies...I am learning...have a lot to learn.  Catherine

1 hour ago, cbaldwin said:

I am learning...have a lot to learn.  Catherine

But THAT is EXACTLY the beauty of our profession Catherine!  I am now retired, and have since learned about a novel antigen in the Gerbich Blood Group System and a novel antigen in the Kell Blood Group System.  Problem is, I no longer get paid for this knowledge!!!!!!!!!!!!!!!!!!

16 minutes ago, Malcolm Needs said:

But THAT is EXACTLY the beauty of our profession Catherine!  I am now retired, and have since learned about a novel antigen in the Gerbich Blood Group System and a novel antigen in the Kell Blood Group System.  Problem is, I no longer get paid for this knowledge!!!!!!!!!!!!!!!!!!

But since you have learned about novel antigens, maybe in your spare time you could write a (wait for it!)  NOVEL!

2 hours ago, cbaldwin said:

Thank you for this information. 

I just found the handouts from a lecture Sue Johnson gave in March 2016 at an Immucor Users meeting and I have attached them in case anyone is interested.  It's very good.  She discusses the molecular basis of weak D and partial D and the variability of reagents and methodology, also the recent recommendations of the Inter-organizational Work Group on RHD genotyping for managing pregnant women and transfusion recipients who have a serologic weak D phenotype.

  On page 18 she states that there is a new CPT code 81403 for RHD genotyping (Tier 2 molecular pathology procedure, Level 4) and that reimbursement rates for the Tier 2 code are being established.  Also that the ACOG is updating its Practice Bulletin to recommend molecular testing.

I just got a new phone number to call to see if I can get the price that we will be charged if we request this test.  My OBGYN physicians would like to know.

Catherine

Johnson Handouts.pdf

I was incredibly privileged to hear Sue give a similar lecture on the BioRad Course in Cressier in Switzerland in March 2015, when she explained the difference between a Weak D and a Partial D using "Reece's Pieces" (if I have the name correct) of different colours to demonstrate the different RhD epitopes.  Sadly, I managed to eat all my "Reece's Pieces" before Sue got as far as Weak D Type 1!

19 minutes ago, mollyredone said:

But since you have learned about novel antigens, maybe in your spare time you could write a (wait for it!)  NOVEL!

I am going into hiding for ten years now!!!!!!!!!!!!

Prof. Theirry Burnouf, Prof. Axel Seltsam, Sue Johnson and some English guy ay Cressier in 2015.

4 hours ago, Malcolm Needs said:

But THAT is EXACTLY the beauty of our profession Catherine!  I am now retired, and have since learned about a novel antigen in the Gerbich Blood Group System and a novel antigen in the Kell Blood Group System.  Problem is, I no longer get paid for this knowledge!!!!!!!!!!!!!!!!!!

So now you have an exciting hobby?

8 hours ago, cbaldwin said:

So now you have an exciting hobby?

Well, reading has always been a hobby, and, at the moment I am making my way through the book by Steven R Pierce and Marion E Reid, Bloody Brilliant!  A History of Blood Groups and Blood Groupers. (and it really is "Bloody Brilliant too) and reading about all the "names" who I have been fortunate to meet and/or work with.

On 1/20/2017 at 1:13 AM, Malcolm Needs said:

Well, reading has always been a hobby, and, at the moment I am making my way through the book by Steven R Pierce and Marion E Reid, Bloody Brilliant!  A History of Blood Groups and Blood Groupers. (and it really is "Bloody Brilliant too) and reading about all the "names" who I have been fortunate to meet and/or work with.

I am reading the same book right now and am very happy to learn about a history of how this field is eevolved and the key players in the field. Also, realized I was born a little too late. It would have been nice to live in the era of exciting discoveries. 

You're STILL in that era.   Genetics is discovering new things every day - not just about blood grouping either

On ‎1‎/‎16‎/‎2017 at 11:59 PM, Malcolm Needs said:

Could I suggest the term "molecular Techniques", rather than "genotyping", as the two terms "(pheno)typing" and "(geno)typing" are, sadly, often confused, particularly by the "lay person" at the front of the office taking calls?  It might work/it might not!

Hello!

The results for the Immucor HEA PreciseType test are a predicted phenotype based on the genotype. Wondering how you feel about the term "molecular phenotype" for that test?

Thanks

43 minutes ago, hmlange said:

Hello!

The results for the Immucor HEA PreciseType test are a predicted phenotype based on the genotype. Wondering how you feel about the term "molecular phenotype" for that test?

Thanks

I actually prefer the term "predicted phenotype", on the grounds that this is what a genotype produces.

On ‎1‎/‎19‎/‎2017 at 10:05 AM, cbaldwin said:

Just found out...our reference lab charges $305.  Thanks all for your replies...I am learning...have a lot to learn.  Catherine 

Catherine,  I am looking for a reference lab that can do this testing for around $300.  If you wouldn't mind letting me know who yours is, I would appreciate it (PM, email, or phone call are fine).

Grifols is still doing our rare ones - through send outs from the United Blood Services, Tempe AZ IRL, but the price is now over $500.  Also -- they prefer a tube that has not been opened (risking cross contamination) for other testing, including automated.  Theirs seems to be a molecular test that leads to a RH Type decision (prediction?). 

I have not been able to charge our pts, but appreciate the new CPT code.  Might get that to work, but the results take too long to get back for most of our outpt encounters.  (about 1 week.)