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Test Code RHOG RhoGAM® Work-up, Blood

Methodology

Red Cell Agglutination

Note:  1. This test is performed on Rh-negative mothers only; it is not indicated for Rh-positive patients.

2. Specimen must be drawn post-delivery, post-miscarriage, or post-ectopic pregnancy.

3. The following tests will be performed before the issuance of RhoGAM® by the Aspen Valley Hospital (AVH) Laboratory:  #ABO “ABO Group, Blood”; #ABSC “Antibody Screen, Blood”; #FETSC “Fetal Screen, Blood”; and #RH “Rh Type, Blood.” (Fetal screen will not be performed on women with ectopic pregnancy, miscarriage, or post-therapeutic abortion.)
4. If the fetal screen is positive, “Kleihauer-Betke Acid Elution” will automatically be performed by Valley View Hospital in Glenwood Springs, Colorado at an additional charge to determine how many vials of RhoGAM® must be administered.

Performing Laboratory

Aspen Valley Hospital

Physician Office Specimen Requirements

Specimen must arrive within ≤72 hours of draw.

 

Submit only 1 of the following specimens:

 

Preferred:

Blood

Container/Tube:  Pink-top (EDTA) tube(s) - Dark green-top (sodium heparin) tube or yellow-top (ACD) tube is also acceptable.

Specimen:  10 mL (minimum volume:  2 mL) of EDTA whole blood

Transport Temperature:  Ambient

Collection Instructions: 

Note:  1. Indicate blood on request form.
2. Label tube(s) with the patient’s name (first and last), date and actual time of draw, initials of phlebotomist, and as blood.

 

Alternate:

Plasma

Container/Tube:  Pink-top (EDTA) tube(s) - Plasma gel tube is not acceptable. Dark green-top (sodium heparin) tube or yellow-top (ACD) tube is also acceptable.

Specimen:  10 mL (minimum volume:  2 mL) of EDTA plasma
Transport Temperature:  Ambient
Collection Instructions:  If there is a delay in transport of ≥1 hour, separate plasma from cells and place in a screw-capped vial. Send both plasma and red cells to laboratory for testing.

Note:  1. Indicate plasma and red cells (if appropriate) on request form.
2. Label tube(s) with the patient’s name (first and last), date and actual time of draw, initials of phlebotomist, and as plasma and red cells (if appropriate).

 

Serum
Container/Tube:  Orange-top tube(s) or plain, red-top tube(s) - Serum gel tube is not acceptable.

Specimen:  10 mL (minimum volume:  2 mL) of serum
Transport Temperature:  Ambient

Collection Instructions:  If there is a delay in transport of ≥1 hour, separate serum from cells and place in a screw-capped vial. Send both serum and red cells to laboratory for testing.

Note:  1. Indicate serum and red cells (if appropriate) on request form.
2. Label tube(s) with the patient’s name (first and last), date and actual time of draw, initials of phlebotomist, and as serum and red cells (if appropriate).

Reference Values

Not applicable

Day(s) Test Set Up

Monday through Sunday

Test Classification and CPT Coding

85461 - fetal screen

86850 - antibody screen

86900 - ABO

86901 - Rh (D)

90384 - RhoGAM®

88312 - Kleihauer-Betke (if appropriate)