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Test Code BLOD1028 Therapeutic Phlebotomy

Useful For

The treatment of hemochromatosis, polycythemia, and porphyrias.  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.

Methodology

Phlebotomy using sterile technique

Performing Laboratory

Bozeman Health Outpatient Services at North 19th

Specimen Requirements

Prior to collection:

  1. Review patient's diagnosis, reason for procedure, and volume of blood to be drawn.
  2. Obtain necessary patient information before draw.  This may include but is not limited to the following:
    • Hemoglobin
    • Hematocrit
    • Ferritin
    • Blood pressure
    • Temperature
  3. Before proceeding, review above criteria for acceptable limits with reference to the therapeutic phlebotomy procedure and physician instructions.

Specimen Type: Whole blood

Container/Tube: Blood unit collection bag

Specimen Volume: Physician determined

Specimen Minimum Volume: Physician determined

Collection Instructions:  Collect blood according therapeutic phlebotomy procedure and physician instructions.  Closely observe patient during procedure and follow up with Post Therapeutic Phlebotomy Instructions for Patient  form below.

Specimen Rejection:

If patient is not tolerating blood draw or vital signs are not within range, the procedure may be stopped at any time.

Reference Values

 

Vital Sign Acceptable Range
Blood Pressure Systolic: 90-150 mmHg
Diastolic: 50-90 mmHg
Pulse 60-100 beats/minute
Temperature

97.7 °F (36.5 °C) - 99.5 °F (37.5 °C)

 

 

Test Cutoff Value Action
Hemoglobin < Hgb cutoff (specified by the Provider)

Therapeutic Phlebotomy not indicated

Hematocrit <Hct cutoff (specified by the Provider)
<45 % (if no cutoff was specified by Provider)
Ferritin <50 ng/mL

Therapeutic Phlebotomy not indicated (unless otherwise specified by the Provider)

Blood Pressure >180 systolic mmHg

Wait 15 minutes and repeat blood pressure.  If still above these levels, call ordering provider and get confirmation to proceed
 

>100 diastolic mmHg
>150 systolic mmHg

Wait 15 minutes and repeat blood pressure.  If still above these levels, call the provider’s office to confirm patient has been identified as hypertensive (unless this step has been done and documented on a previous visit)

>90 diastolic mmHg
<80 systolic mmHg

Consult the patient’s care provider prior to the procedure.  Deferral is recommended
 

<50 diastolic mmHg
Pulse >100 beats/min

Wait 15 minutes and retake pulse.  If repeat pulse is still >100 or <60, call the provider to inform them of high/low pulse and get confirmation to proceed

<60 beats/min
Temperature >99.5 ˚F (37.5 ˚C)

Consult ordering provider whether or not to proceed

<97.7 ˚F (36.5 ˚C)

 

 

Day(s) Test Set Up

Monday through Friday

 

Turnaround Time: 1 hour

Test Classification and CPT Coding

99195