Reimbursement for performing ABO confirmation testing on a second separately collected specimen

The Medical Director at a University Transfusion Service reports that his transfusion service performs ABO confirmation testing on a second separately collected specimen for patients who initially type as group A, group B, or group AB (and have no historical record against which to compare the ABO results). They have not yet begun requesting reimbursement for this practice, and would like to do so. He is curious if any institution is reimbursed for this kind ABO confirmation testing. If so, what is the appropriate CPT code?

Editors' Note: The editors believe that the discussion, Should pre-transfusion ABO/Rh testing be performed twice, and if so, on different samples or by different personnel?is germane to this inquiry.

The following comments have been received.

ADDENDA October 26, 2009

1. A transfusion medicine physician at an academic medical center in Southern California reports that at her institution a second sample is required as described below, however, they do NOT bill for this testing because in their opinion it is for quality assurance only.
   
   Requirement for a second sample for ABO/Rh testing:

   If the Blood Bank does not have a previous ABO/Rh on file for the patient, and the patient’s initial blood type is other than type O, the Blood Bank will request a second sample to be collected for an ABO/Rh confirmation.
   Exception: Infants <4 months old unless they are receiving directed blood other than type O and/or infants requiring platelet transfusion.

   1. The second sample must be properly labeled per institutional protocol.
   2. It is preferable for a different phlebotomist to draw the second sample.
   3. The second sample must be from a separate blood collection. It is not acceptable to draw 2 tubes at the same time and label each with a different time.
   4. If blood is needed prior to the ABO/Rh confirmation, type O blood will be issued by the Blood Bank. Due to the limited supply of type O blood, a second sample should be sent to the Blood Bank as soon as possible so type-specific blood may be issued.

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