Oncology & Hematology Coding Alert
Do Not Submit More Than 1 Unit of 36430 per Transfusion
Question: Our physician transfused two units of blood. Can we submit two units of code 36430 for this transfusion?
New York Subscriber
Answer: Report 36430 (Transfusion, blood or blood components) only one time per transfusion, regardless of how many units are administered. You should not report code 36430 twice for two units of blood transfused. Additionally, submit code P9017 (Fresh frozen plasma [single donor], frozen within 8 hours of collection, each unit) twice for the two units of blood. https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c04.pdf (pg. 145-Section 231.8) “Billing for transfusion services”.
Note: Generally, to be reimbursed, codes for both the transfusion and the blood product must be submitted to the payer.
Oncology & Hematology Coding Alert
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