How To Use CPT Code 36450

CPT 36450 describes the procedure of exchange transfusion, specifically for newborn patients. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 36450?

CPT 36450 is used to describe the procedure of exchange transfusion in newborn patients. This code is specifically used when the provider slowly removes a specific amount of blood from the umbilical blood vessel of a newborn and simultaneously injects an equal amount of healthy blood or plasma from a donor. The purpose of this procedure is to treat severe cases of jaundice and control the amount of bilirubin in the blood.

2. Official Description

The official description of CPT code 36450 is: ‘Exchange transfusion, blood; newborn.’ It is important to note that when a partial exchange transfusion is performed in a newborn, a different code, 36456, should be used. Additionally, modifier 63 should not be reported in conjunction with 36450. For manual red cell exchange, other codes such as 36455 and 36456 should be used. For automated red cell exchange, code 36512 is appropriate.

3. Procedure

1. In this procedure, the provider accesses the umbilical vein of the newborn and inserts a catheter to withdraw blood.
2. A specific amount of impure blood is slowly withdrawn from the baby’s umbilical vein.
3. Simultaneously, an equal volume of donor blood is introduced into the newborn’s bloodstream.
4. This process is performed in multiple cycles at different time intervals.
5. After the procedure, the provider removes the catheter and stops any bleeding.

4. Qualifying circumstances

CPT 36450 is performed in newborn patients who require exchange transfusion to treat severe cases of jaundice. Jaundice is a condition characterized by yellow discoloration of the skin and whites of the eyes, caused by an excess amount of bilirubin in the blood. The procedure is specifically performed on newborns, and the provider must access the umbilical vein to perform the exchange transfusion.

5. When to use CPT code 36450

CPT code 36450 should be used when performing exchange transfusion in newborn patients. It is important to note that this code is not appropriate for partial exchange transfusions, which should be reported using code 36456. Additionally, modifier 63 should not be used in conjunction with 36450. For manual red cell exchange, other codes such as 36455 and 36456 should be used. For automated red cell exchange, code 36512 is appropriate.

6. Documentation requirements

To support a claim for CPT code 36450, the provider must document the following information:

• Patient’s age and indication for exchange transfusion
• Specific details of the procedure, including the amount of blood withdrawn and the volume of donor blood introduced
• Date and time of the procedure
• Any complications or adverse events that occurred during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 36450, ensure that the procedure is performed on a newborn patient and involves the exchange transfusion of blood. It is important to follow the specific guidelines for reporting partial exchange transfusions, manual red cell exchange, and automated red cell exchange. Modifier 63 should not be used in conjunction with 36450. It is also important to consider any additional codes that may be necessary to accurately report the services provided during the exchange transfusion procedure.

8. Historical information

CPT code 36450 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A newborn patient with severe jaundice undergoes exchange transfusion to control the amount of bilirubin in the blood.
2. A provider performs exchange transfusion on a newborn with Rh incompatibility to prevent complications.
3. A baby born prematurely requires exchange transfusion to treat severe jaundice caused by an immature liver.
4. A newborn with ABO incompatibility undergoes exchange transfusion to manage the high levels of bilirubin in the blood.
5. A provider performs exchange transfusion on a newborn with hemolytic disease of the newborn to prevent further complications.
6. A baby with a rare blood disorder undergoes exchange transfusion to maintain stable blood parameters.
7. A provider performs exchange transfusion on a newborn with anemia to improve the overall blood composition.
8. A baby with a genetic disorder requires exchange transfusion to manage the excessive bilirubin levels in the blood.
9. A newborn with liver dysfunction undergoes exchange transfusion to alleviate the symptoms of jaundice.
10. A provider performs exchange transfusion on a newborn with a severe infection to support the body’s immune response.