Pathology/Lab Coding Alert

Capture $12.91 for new transfusion medicine code

Pathology codes for transfusion-related testing and processing didn't include a volume-reduction procedure -- until now. Follow our expert's advice to learn when you can use the new CPT 2006 code to capture pay for this service.
 
The new code is CPT 86960 (Volume reduction of blood or blood product [e.g., red blood cells or platelets], each unit). The procedure involves centrifuging the donor blood and transferring the supernatant fluid/plasma to a different bag using sterile technique. Medicare will pay $12.91 for the procedure.

Code for Reducing ABO Incompatible Plasma

When a patient needs platelets but the hospital only has units with incompatible A and/or B plasma, the transfusion can proceed -- by reducing the amount of plasma with the offending antibodies. The reduction minimizes the chance for hemolysis of recipient red-blood cells.
 
What to do: "You can now report this volume-reduction step with 86960," says Suzanne H. Butch, MA, M(ASCP)SBB, administrative manager at University of Michigan's Blood Bank and Transfusion Services in Ann Arbor.
 
Although more common for platelet transfusions, the lab may also reduce plasma volume for red-blood cell transfusions, in some cases. You should report that service with 86960 as well.

Don't Miss Neonate and Fluid-Restricted Patients

Aside from volume reduction for incompatible ABO plasma antibodies, transfusion centers may also reduce volume for neonatal recipients or patients with kidney or heart problems on restricted-fluid orders.
 
Tip: Regardless of the reason for the procedure, you should report blood volume reduction using 86960.

Try Your Hand at Coding This Example
 
A patient with A positive blood requires a platelet transfusion. The hospital does not have A positive platelets available, but does have O positive platelets. Because the O blood type contains anti-A antibodies in the plasma, the lab reduces the plasma content for two units of platelets and transfuses the patient.
 
Do this: Report the transfusion as 36430 (Transfusion, blood or blood components). The correct code for the volume reduction is 86960. Opportunity: Because the lab concentrated two units, you should code the procedure for each unit and report 86960 x 2.