BLOOD DONOR AUTOLOGOUS PROGRAM

General Information

HLAB/HOL Code: TRANS. RQN.
UPHSM LIS Test #:
Schedule: Monday-Friday by appointment
Testing Time: 1 day
Testing Lab: UP Health System-Marquette

Specimen Info
Only 1 specimen type required, unless otherwise specified

Volume:
Temperature:
Tube Type: NA
Collection Info:
Test performed at: MGH Upper Peninsula Regional Blood Center:
Marquette, Sault Ste. Marie,  Escanba, Hancock, Iron Mountain
NOTE:
1. Physician orders must be sent to the site where the autologous  collection is expected.
2. Units should be drawn 35 and 7 days of the expected reinfusion.

Clinical Utilities

Collection of blood components for prescheduled subsequent reinfusion.

CPT Codes

NA

* The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding
is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

Reference Range

NA