Practice Management Alert

Reader Question:

Start with 36430 for Transfusions

Published on Mon Feb 22, 2010

Question: My provider wants to start doing blood transfusions in the office. This is new for me, so I need to know what codes to use to bill for this service. Where do I start?

Answer: Blood transfusion codes begin with 36430 (Transfusion, blood or blood components).

A CPT Assistant (March 2001) Coding Consultation Q&A states you should report 36430 "only one time per transfusion, regardless of how many units are administered."

Additional support: CMS's medically unlikely edits (MUEs) list a limit of 1 for 36430, meaning that's the maximum number of units the majority of patients should require.

Remember: 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).

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 don't supply and code both the transfusion and blood product, payers may not offer reimbursement.

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