ABO incompatibility newborn, Negative DAT

Hello! I had a question about ABO incompatibility.

For example, mother of infant O positive, antibody negative. Infant A negative, DAT negative. No CBC obtained, however infant had HRZ bilirubin level within 24 hours and was treated with phototherapy and/or formula supplementation to bring down bilirubin levels. Coding clinic states it is not a requirement to have a positive DAT in order to code ABO incompatibility, which ultimately codes to P55.1 ABO isoimmunization. Denial from payer due to clinical validation. Is this able to be appealed and if so what should we mention/reference. I have a lot of references stating that a positive DAT is not a requirement, but our denials specialist says that the infant must have a positive DAT/iDAT in order for it to be coded.

Thanks in advance!


  • As an update, after digging though multiple recent research articles, ABO is very likely to have a negative dat, but within that if I send a query I will ask them also about any other possible reason for hyperbili requiring phototherapy since other causes should also be searched for in the case of a negative dat.

  • I had a case like this but the doctor unfortunately disagreed with ABO incompatibility. I did get Newborn dehydration though so wasn't a total wash.

    Good luck.

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