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Billing for neonatal aliquots of leukoreduced CMV-negative irradiated apheresis platelets

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Will anyone who is willing explain how they apply charges when these products are transfused to their neonates and what codes are utilized?

 

Thanks in advance.

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We bill by volume received. We have service codes for different volumes and the computer billing system selects the correct one based on thevolume of the product.

Billing for Split Units

Blood Groups: Section 231.4 directs hospitals to report HCPCS code P9011 (Blood (split unit), specify amount) for the blood product transfused as well as CPT 86985 (Splitting of blood or blood products, each unit) for each splitting procedure performed to prepare the blood product for a specific patient. We have received feedback from hospitals expressing concern that reporting in this manner will have a negative impact on reimbursement. We recommend that CMS ensure that the total payment for blood products that have been split (taken in the aggregate) be at least equal to the APC rate applicable before the unit was split. We also urge CMS to clarify whether special Medicare coding or documentation requirements exist for HCPCS code P9011 and, if so, to specify what those requirements are.

CMS: “Where a unit of blood is split, the blood remaining in the unit can be given to another patient and billed to Medicare with P9011 or to another payer, if the second patient is not a Medicare beneficiary. Moreover, the unit may be split into more than 2 portions and, in some cases, the hospital will receive more, not less, total payment for the unit of blood than if they had not split the unit. . . . n a system of averaging, total overall payment should be appropriate, particularly when the frequency of billing for split units is so low.”

“We are not aware of [documentation] requirements [related to the instruction to hospitals to specify the amount of product billed under P9011] other than within the definition of the code. We will pursue with the HCPCS editorial board a revision of the code for the 2007 HCPCS to delete the words ‘specify amount.’”

 

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We used to reduce volume platelets here, but haven't done in years.  It produced a substandard product.  We use aliquots of apheresis platelets.  They are usually in syringes.  We have a neonatal ICU that stays full.

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1 hour ago, Baby Banker said:

We used to reduce volume platelets here, but haven't done in years.  It produced a substandard product.  We use aliquots of apheresis platelets.  They are usually in syringes.  We have a neonatal ICU that stays full.

Thanks for the info. Our blood center has been trying to get our biggest hospital on board to do their own aliquots. 

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