Oncology & Hematology Coding Alert

Question: What is leukocyte reduction? Our physician documented leukocyte reduction for platelet transfusion. Is 9031 the correct HCPCS code for this component? Is there another HCPCS code that we can submit for the platelet products with leukocyte reduction?

Georgia Subscriber

Answer: Leukocyte reduction is a process to which is the filtered removal of contaminating leukocytes  before platelet transfusions. Leukocyte reduction helps to prevent alloimmunization to donor HLA antigens. It prevents immune mediated destruction of platelets and febrile non-hemolytic transfusion reactions (FNHTR).

Leukocyte reduction may be done before storage of platelets or before transfusion.

• Pre-storage leukocyte reduction may be done within 24 hours of collecting the blood by using inline filters at the time of, or after, collection.
• Pre-transfusion leukocyte reduction is also called bedside leukoreduction. This is done prior to transfusion by using gravity-based filters at the time of transfusion (less preferred) or by transfusion service prior to issuing the platelets.

The HCPCS code P9031 (Platelets, leukocytes reduced, each unit) applies to a unit of non-irradiated leukocytes reduced, platelets for transfusion. Platelets may also be irradiated using gamma radiation to destroy the ability of lymphocytes (a type of leukocyte) to respond to foreign antigens, such as those in the recipient’s blood. In the case where radiation is used, HCPCS code P9033 (Platelets, leukocytes reduced, irradiated, each unit) describes the blood product used.

Pheresis can also be used for leukocyte reduction.  In pheresis, a centrifuge device to separate blood components.  The designated component (in this case platelets) is removed and the remaining blood components are retransfused into the donor.  Then the choice becomes, irradiated or not.

• P9035, Platelets, pheresis, leukocytes reduced, each unit
• P9037, Platelets, pheresis, leukocytes reduced, irradiated, each unit.