THERAPEUTIC PHLEBOTOMY Who will Perform the Procedure? Advise your patient to eat a good meal and drink plenty of fluids before undergoing phlebotomy. The linkage and maximum fee rate will apply retroactively to outpatient fee-for-service (FFS) claims with dates of service (DOS) on or after February 13, 2017. There is a $150 fee per therapeutic phlebotomy for all patients other than those with a diagnosis of hereditary hemochromatosis or secondary polycythemia due to testosterone replacement therapy, since these units may be used in some cases for transfusion to patients. How frequent you’ll need therapeutic phlebotomy is determined by the seriousness of the condition. The treatment of hemochromatosis, polycythemia, and porphyrias. Procedure: The following chart outlines the guidelines for blood drawing that is practiced at Infusion Nurses Society (2011). A blood pressure cuff is used as a tourniquet in order to increase the blood flow into the the median cubital vein. Parker, D., Deel, P., Arner, S. (2004) Iron out the Details of Therapeutic Phlebotomy. One or two peripheral intravenous lines (PIVs) are started to perform the procedure if you do not have any other type of vascular access device (CVL or portacath). Once the vein of interest is located, the blood pressure cuff is deflated. Eat a light meal before you go to the infusion center. After the right amount of blood is drawn, the nurse will remove the needle and place a pressure bandage (bandage that wraps around your arm) over the needle site (the place on your arm where the needle was). It’s also called a blood draw or venipuncture. Informed Consent for Therapeutic Phlebotomy for Polycythemia Vera. Phlebotomy is when someone uses a needle to take blood from your vein. The vein is palpated to ensure its visibility and location. Therapeutic Phlebotomy is the same as donating whole blood. PURPOSE  To safely remove a specific amount of blood from a patient with a clinical indication as ordered. code 99195 ‒ Phlebotomy, therapeutic (separate procedure) to revenue code 940 ‒ Other Therapeutic Services – General, and will assign maximum fee pricing in the amount of $105.04. This means it tends to make it simpler for the blood to perform its functions effectively. Utilizing Red Cross therapeutic apheresis services enables hospitals to provide these services to their patients without investing in equipment and the training of specialized staff. Definition Therapeutic phlebotomy is the removal of blood from your body to treat a medical condition. Tell him to move slowly afterward when changing positions or standing, to prevent light-headedness, faintness, and a rapid drop in blood pressure. If you are on any medications, you may take them at your usual time unless your doctor instructs you otherwise. Page 1 of 1 Please see links below for Therapeutic Phlebotomy procedure, which is now located in Lippincott. A signed IRB approved consent and a physician’s order are necessary for the initiation of phlebotomy and for blood sampling. Therapeutic Phlebotomy Guidelines . The World Health Organization has issued practice guidelines for nurses who draw blood, which is referred to as phlebotomy. The phlebotomy procedure must be performed to preserve venous integrity. MATERIALS: Nitrile gloves. During your therapeutic phlebotomy procedure, a nurse will use a needle connected to a blood collection bag to draw a certain amount of your blood. However, there are many scenarios where the risks outweigh the benefits. As a result, oncology nurses often are required to care for these patients. By William Henderson. 1.Bloodletting – standards. A nurse checks your child’s blood pressure, heart rate, breathing, temperature, and oxygen level before, during, and after the procedure. A phlebotomy of one pint of blood will generally lower hematocrit by about 3 percent. 2.Phlebotomy – standards. “Therapeutic phlebotomy” means the removal of whole blood from a donor for the purpose of medical treatment. THERASAFE is the only FDA approved device specifically designed for Therapeutic Phlebotomy procedures. The Therapeutic Phlebotomy (TP) Procedure Described: The process varies slightly depending on the treatment site; following is a general step by step of what takes place. (800) 266-4033 or (425) 453-5098 Fax (425) 251-1977. Therapeutic phlebotomy cuts down the number of blood cells and reduces the blood volume. Your blood will be drawn by Medical Technol-ogists or Medical Laboratory Technicians who have special training in this process. THERAPEUTIC PHLEBOTOMY: The removal of a specific amount (volume) of blood from a patient for treatment of a specific condition or disease. Hereditary hemochromatosis is an inherited condition that causes increased absorption of iron from the diet resulting in iron overload. Email:therapeuticphlebotomy@bloodworksnw.org. This is possible once the blood pressure cuff is inflated. 1. (2008). Time Square, 660 SW 39thStreet, Suite 245, Renton, WA 98057. Therapeutic Phlebotomy Policies and Procedures for Infusion Nursing. The procedure is ordered as a treatment for hereditary hemochromatosis, polycythemia vera, and secondary polycythemia. Therapeutic Phlebotomy, retrieved Aug 20/08 from Mosby’s Nursing Skills: Blood transfusions are the most common procedure performed during hospitalizations and undoubtedly help patients. Appropriate Maximum Phlebotomy Volumes Purpose: To provide a guideline for performing safe phlebotomy procedures on our neonate, infant and pediatric population. A Therapeutic Phlebotomy Procedure. The removal of blood via therapeutic phlebotomy can improve symptoms and reduce the risk of developing clots. It makes it easier to control the pressure. After the preliminary tests for hemoglobin and hematocrit are finished, a phlebotomist prepares you for the procedure. Therapeutic phlebotomy is a blood draw procedure usually prescribed by a physician as part of a treatment of various medical conditions associated with accumulation of excess iron in the body. WHO … Therapeutic phlebotomy is done through an IV (by vein) or central line if your child has one. THE PROCEDURE IS PERFORMED IN SUCH A MANNER AS TO MAINTAIN SAFETY OF THE PATIENT AND THE PHLEBOTOMIST. Nursing 2004, vol 34, number 2. Useful For. You will have a mini-physical examination You will sit in a chair in the treatment area for your procedure. Therapeutic phlebotomy is very similar to what happens when donating blood, but this procedure is prescribed by physicians as a way to bring down blood hematocrit and viscosity. Procedure:Therapeutic Phlebotomy consists of inserting a needle … … Polycythemia (rubra) vera –to decrease red cell mass 2. Traditional methods for performing the therapeutic phlebotomy procedure utilized 500ml glass vacuum bottles, blood bags or modified blood bags, each method having its own clinical precautions. THERAPEUTIC PHLEBOTOMY FLOWSHEET Time Time Amount Time Time Amount Time left Infusion. 1. This procedure is done under the supervision of the medical director of the laboratory. Lippincott® Procedures is your online source for instant, evidence-based procedure guidance at the point of care. WebMD explains the process, risks, and side effects. #3 Medications to lower the number of blood cells They also check to see if your child is anxious, irritable, dizzy, pale, or thirsty. Therapeutic Phlebotomy is a procedure performed in an outpatient setting (Clinic or Physicians Office) to remove red blood cells (RBCs) from the body. “System” means the organizational structure, responsibilities, policies, processes, procedures, and resources established by the licensee to achieve the requirements of these rules. UPDATED PHLEBOTOMY PROCEDURES Presented by: Helen Maxwell Executive Director, ASPT 1 Procedures for the Collection of Diagnostic Blood Specimens by Venipuncture; Approved Standard—Sixth Edition December, 2010 One common procedure nurses perform is therapeutic phlebotomy, where about 500 ml of blood is removed through a large-bore needle over 15–30 minutes. Pump it up to 60mmHg to find a vein and/or perform venipuncture, then lower pressure to 30 to 40mmHg for the procedure. Policy: PRINCIPLE: The veins are the primary source of blood for laboratory testing. Scope: All personnel drawing blood specimens, i.e., by direct phlebotomy or venous/arterial lines. Policy: All clinical research nurses or research project assistants must be certified in the performance of phlebotomy before performing this procedure without supervision. Proehl, JA. Availability In most cases, therapeutic apheresis professionals are available 24 hours a day / 7 days a week for scheduled and / or emergency service. Tourniquet. Phlebotomy, Therapeutic Title: Phlebotomy, Therapeutic - Lippincott Procedure Patient Age Group: ( ) N/A ( ) All Ages ( ) Newborns ( ) Pediatric (X) Adult Applies To: UNM Hospitals, UNMCC WHO Library Cataloguing-in-Publication Data WHO guidelines on drawing blood: best practices in phlebotomy. Your institutions should have policies and procedures regarding phlebotomy for nursing, including training classes on the proper procedures for blood draw, you should review these procedures prior to performing any blood draws. 4th Edition pp 144-145. 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