Q/A: Reporting irradiation of blood products
APCs Weekly Monitor, September 23, 2011
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Q. How should we report the irradiation of blood products? We have been reporting the P code for the packed red blood cells (PRBC) and CPT® code 86945 (irradiation of blood product, each unit) for the irradiation, but we just heard someone say this is inappropriate. How should we be reporting this?
A. First, be sure you have a physician order that is specific for irradiated PRBCs and document medical necessity for the irradiation of the product. Some P codes for blood products include “irradiated” in the description and these should be used to report the blood product that was ordered and transfused.
For example, the physician orders “Transfuse 2 units of leucoreduced,irradiated PRBCs.” You would report the transfusion procedure code (36430) and P9040 (Red blood cells, leukocytes reduced, irradiated, each unit) with quantity of two.
The P code specifically reports the type of cells ordered and transfused. The only time you should “add on” CPT 86945 separately is when no P code describes the irradiated product. See the Medicare Claims Processing Manual (Pub 100-04) Chapter 4, section 231.5.
Editor’s note: Denise Williams, RN, CPC-H, director of revenue integrity services atHealth Revenue Assurance Associates, Inc., in Plantation, FL, answered this question.
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