UPMC Presbyterian Hospital
Pittsburgh, Pennsylvania
DEPARTMENT OF PATHOLOGY
POLICIES AND PROCEDURES
Policy: Procedure for Accepting Non-ADRC Affiliated Brain Only Autopsies
Effective Date: May 2013
1.0POLICY/PRINCIPLE
The purpose of this policy is to establish guidelines for acceptance of non-ADRC (Alzheimer’s Disease Research Center) affiliated brain only autopsies.
2.0SCOPE
This policy applies to all non-ADRC brain-only autopsy cases, which include both UPMC and non-UPMC patients.
3.0RESPONSIBILITY
This policy is the responsibility of all pathology staff that are involved in the triage and acceptance of autopsy cases from outside hospitals. Family requests for private autopsies should be pre-approved by the autopsy pathologist on call.
4.0PROCESS
4.1Initial Procedures
4.1.1In most cases, the initial call regarding the autopsy will be received by the ADRC answering service. If the deceased is not affiliated with or a patient of the ADRC, then the answering service will contact the pathology department (Monday-Friday 7:00-5:30pm) or decedent affairs consult service (after hours/ weekends) to assess the case.
4.1.2The pathologist on-call or decedent affairs representative will speak with the caller to gather preliminary information such as location of decedent, past clinical history, visit history with UPMC and name and contact information for primary physician or neurologist. The medical director or attending pathologist will make the final determination as to if the deceased will be accepted for autopsy. This will take place M-F during normal operating hours.
4.1.3If it is determined that the deceased is a patient of UPMC, then the autopsy will be performed free of charge. UPMC will also pay for the cost of body transport to Presbyterian. Arrangements for transport should be made through Todd Smith Transport Service.
4.1.4If it is determined that the deceased is not a patient of UPMC, then the family will need to pay for the private autopsy. This needs to be made clear up front. As of June 2012, the cost of a brain-only autopsy is $1000.00. The family will also need to arrange and pay for the body transport.
4.2Autopsy Authorization
4.2.1The pathologist or decedent affairs representative will be responsible for securing autopsy consent from the next of kin. This can be done via witnessed telephone consent or by faxing the autopsy authorization form.
4.2.2At the time of gaining consent, the pathologist or decedent affairs representative should also request the following:
4.2.2.1A copy of the deceased’s medical record
4.2.2.2Name, phone number and address of next of kin for billing purposes
4.2.2.3Name and phone number of primary care physician and/ or neurologist.
4.2.2.4Permission to perform research with diagnostic work-up (part of autopsy authorization form)
4.3Receipt of Materials
4.3.1Upon receipt of the materials at PUH, the patient will need registered into the Medipac system. This can be accomplished by faxing the completed demographic sheet (Attachment 6.1) to registration using the pre-filled fax sheet (Attachment 6.2).
4.3.2The autopsy should then be accessioned following usual protocols.
4.3.3When the autopsy is received and accessioned, notify the department manager or supervisor so that they can arrange for appropriate billing.
4.4Autopsy Examination
4.4.1The technical portion of non-ADRC affiliated brain only autopsies will be performed by the technician or pathologist assistant assigned to the autopsy service according to routine autopsy protocols and cut-off guidelines.
4.4.2The neuropathologist on service should be called prior to brain removal. They should be present to direct any potential tissue banking or special studies.
5.0REFERENCES
N/A
6.0ATTACHMENTS
6.1UPMC Presbyterian Outside Autopsy Registration Demographic Sheet
6.2 Outside Autopsy Fax Cover Sheet
7.0REVIEW AND REVISION HISTORY
Approved / ApprovedMedical Director/Date / Manager/Date
Reviewed: / Date:
Revised: / Date:
Date of Initial Issue: May 2013
UPMC Presbyterian Outside Autopsy
Registration Demographic Sheet
Note: This sheet is only to be faxed to Registration when the autopsy patient is from a non-UPMC facility
All information must be completed:
Patient Name: ______
Date of Birth: ______
Social Security Number: ______
Referring physician name: ______
Fax Cover Sheet
To:PUH Registration
Fax number:M- F 5a-6p 412-647-3496
CC:After 6p and weekends PUH ED
Fax number:412-647-6633
From:Pathology
Telephone number: 412-647-6597
Date:
Re:Outside Autopsies
Number of pages:
(including cover page)
Comments:
Register patient type SR
Guarantor- enter IA number 099996773-9500
FINANCIAL CLASS..YR
Chief Complaint Autopsy sample
Physician name included on patient demo sheet
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