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| iPhone Application Available! |
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Hemoglobin A1C Testing Frequency
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The Office of Inspector General (OIG) has released its Fiscal Year 2011 Work Plan, which describes the investigative, enforcement and compliance activities that it will undertake in the coming year.
OIG will review Medicare contractors for screening the frequency of clinical laboratory claims for HbA1c and determine the appropriateness of Medicare payments. The following testing intervals are considered medically necessary:
- Every 3 months to monitor a diabetic patient's metabolic control
- Every 1-2 months when treatment regimen is altered to improve control
- Every month for diabetic pregnant women
- Patients with uncontrolled type I or II diabetes may be tested more frequently if the medical record contains supportive documentation
An Advance Beneficiary Notice (ABN) should be submitted for Medicare patients whenever a HbA1c is ordered at more frequent intervals than those listed above.
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| Transfusion of Group A2 Platelets to Group O Recipients |
Hospital transfusion services try to provide ABO identical platelets for every patient. However, if ABO identical platelets are not available, it may be necessary to issue ABO nonidentical platelets in an emergent situation. Transfusion of group A or B platelets to group O recipient results in post-transfusion platelet increments that are 20% less than those obtained with ABO identical platelet transfusions. Decreased platelet survival is due to the binding of recipient anti-A and/or anti-B to the transfused donor platelets.
Blood group A is subdivided into A1 and A2 subgroups, accounting for 80% and 20% of group A individuals, respectively. More recent studies have demonstrated that A2 platelets serologically behave more like group O than group A1 platelets. Transfusion of group A2 platelets to group O recipients achieves the same post-transfusion rise in platelet count as transfusion of ABO identical platelets and is not associated with any adverse reactions. Accordingly, transfusion services can issue A2 platelets for group O recipients when group O platelets are not available.
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| Kindle Book |
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