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AUTOLOGOUS, Component Collection (007-0151) "AUTOLOGOUS, Component Collection" Synonyms: Autologous Whole Blood Donation CPT 4 Code: 86890 Test Order Mnemonic: BILL AUCRG Test Includes: Removal of blood or components from a donor for subsequent intraoperative or postoperative re-infusion. Lab: Blood Bank Request Form: Autologous Transfusion Request Form Patient Preparation: Should have a hearty meal prior to donation, no alcoholic beverages for 12 hours prior, and be in generally good health. The attending physician should consider supplemental iron therapy. Patients known to be positive for HBsAg, HCV, or HTLV-I will not qualify as autologous blood donors. Collection: Drawn by Blood Bank staff Storage Instructions: Blood unit will be kept in Blood Bank refrigerator for up to 35 days. Causes for Rejection: Patient/donor being treated for bacteremia, or have inadequate veins, and poor toleration of phlebotomy, or is positive for HBsAg, HIV, HCV, or HTLV-I. Availability: Patients are scheduled Monday-Friday, Blood Bank Donation time 8:30 a.m. – 5:00 p.m., Room 1.210 John Sealy Annex. Turnaround Time: 3 days Special Instructions: Donation must be scheduled with Blood Bank. Patient's physician must fill out request form authorizing autologous donation. Volume: 450 mL Minimum Volume: 300 mL Container: Blood bag (CPDA-1) Reviewed/Revised 02/15/2006 by D. Madrigal, MT(ASCP)SBB |
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