Wiki injection vs transfusion

[Ginny901]

Hi My name is Ginny, When a person has a paracentensis and they develope a lack of Albumin in their blood system (albumin is a blood serum, a blood componet) and the Doctor replenishes the Albumin by injection (sometimes up to 60 min or more) . What is the correct CPT code. 36430--Transfusion, blood or blood componets or 96365 -- Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or durg); initial up to 1 hour . We have the 3M system and it brings me to the code 36430, which I agree is the correct code, but I'm told to use 96365. Does 96365 include blood and blood componets? thank you .

 

[Mojo]

Hi Ginny:

http://qhr.knowledgebase.co/article/infusion-code-for-albumin.html

Question
What is the infusion code for albumin? 36430 or 96365?

Answer
I would suggest this to be reported as an infusion (96365). According to notes in the HCPCS code book, as of 07/01/05 albumin is not considered a blood product under OPPS.

 

[Ginny901]

injection vs transfusion of Albumin

Hi. The definition of Serum Albumin is , The most abundant protein in human blood. It is produced by the liver and balances the water content of blood. A protein that is important in maintaing blood volume. Albumin is a blood componet.

 

[Mojo]

Albumin is administered as a therapeutic infusion, not as a transfusion. The policies and procedures of infusion and transfusion differ so for billing purposes I can understand reporting 96365 as suggested by qhr.

 

[rspicerRHIT]

Per Coding Clinic for HCPCS, 1Q 2010, page 7: albumin is a blood derivative (not a blood product such as platelets, plasma, etc) and should be reported with 96365.