Wiki Plasmapheresis Help Please!

[LauraF1225]

Hello - I'm getting conflicting information at my organization about plasmapheresis with fresh frozen plasma. I figured I'd ask here to see what anyone else could tell me about billing for it.

So my question is:

Is it appropriate to bill a blood component administration under 36430 for the Fresh Frozen Plasma that is given during the treatment of plasmapheresis or is the administration of the donor Fresh Frozen Plasma a component of the 36514 therapeutic apheresis code?

Thank you for your help!

Laura

 

[liz.gates@imail.org]

Blood admin & plasmapheresis

Hi Laura,

The infusion of fresh frozen plasma is a component of the 36514 therapeutic plasma exchange procedure, so there should not be a separate blood admin charge.

This just came up in my organization a few weeks ago, so I've done a lot of research.

Sources:
o “…plasma exchange is accomplished by isolating and discarding the patient’s plasma, and then returning a replacement fluid to the patient.”1
o “CPT 36514 Therapeutic apheresis for plasma pheresis includes the reinfusion.”2
o “For purposes of Medicare coverage, apheresis is defined as an autologous procedure, i.e., blood is taken from the patient, processed, and returned to the patient as part of a continuous procedure.”3

References:
1. Coding Essentials for Hospital Infusion Services. 2015, pg. 159-160, MedLearn Publishing.
2. Billing for Pheresis and Apheresis Services. 11/15/2017, http://www.aabb.org/advocacy/reimbursementinitiatives/Pages/billingfaq
3. National Coverage Determination (NCD) for Apheresis (Therapeutic Pheresis) (110.14). 11/15/2017, https://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=82&ver=1


Elizabeth Gates, CPC