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Oncology & Hematology Coding Alert

READER QUESTIONS:

Supply May Be Key to Transfusion Payment

Published on Thu May 28, 2009

Question: Should I report 36430 twice if we supply both packed red blood cells and fresh frozen plasma? Montana Subscriber Answer: No. You should report only one unit of 36430 (Transfusion, blood or blood components). Heres why: AMAs CPT Assistant (March 2001) says to report 36430 only one time per transfusion, regardless of how many units are administered. Bonus support: CMSs medically unlikely edits (MUEs) list a limit of 1 for 36430, meaning thats the maximum number of units the majority of patients should require. Dont forget: Report the blood products if you supply them. For example, if you supply one unit of packed red blood cells, report one unit of P9021 (Red blood cells, each unit). And for one unit of plasma, report the appropriate code, such as P9017 (Fresh frozen plasma [single donor],frozen within 8 hours of collection, each unit). If you dont supply and code both the [...]
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