How To Use CPT Code 36455

CPT 36455 describes the procedure of exchange transfusion, specifically for patients other than newborns. 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 36455?

CPT 36455 can be used to describe the procedure of exchange transfusion for patients who are not newborns. This code is used when a specific amount of blood is removed from a patient’s blood vessel and simultaneously replaced with an equal amount of healthy blood or plasma from a donor. Exchange transfusion is commonly performed to treat severe cases of jaundice and control the levels of bilirubin in the blood.

2. Official Description

The official description of CPT code 36455 is: ‘Exchange transfusion, blood; other than newborn.’

3. Procedure

1. The healthcare provider prepares the patient for the procedure.
2. The provider accesses the targeted vein and inserts a catheter to withdraw a specific amount of blood.
3. Simultaneously, the provider introduces an equal volume of healthy blood or plasma from a donor.
4. The procedure 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

Exchange transfusion using CPT 36455 is typically performed for patients who have severe jaundice and elevated levels of bilirubin in their blood. The procedure is not limited to newborns and can be performed on patients of any age. It is important to note that this procedure should only be performed by qualified healthcare providers who have the necessary expertise and training.

5. When to use CPT code 36455

CPT code 36455 should be used when performing exchange transfusion for patients who are not newborns. It is important to ensure that the procedure meets the specific criteria outlined in the official description. If the patient is a newborn, a different CPT code should be used to accurately describe the procedure.

6. Documentation requirements

To support a claim for CPT 36455, the healthcare provider must document the following information:

• Patient’s diagnosis and the medical necessity for exchange transfusion
• Details of the procedure, including the specific amount of blood withdrawn and replaced
• Date and time of the procedure
• Any complications or adverse reactions during or after the procedure
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 36455, it is important to ensure that the procedure meets the specific criteria outlined in the official description. The healthcare provider should also follow any additional billing guidelines provided by the payer. It is important to accurately report the procedure and any associated services or supplies provided during the exchange transfusion.

8. Historical information

CPT 36455 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 patient with severe jaundice undergoes exchange transfusion to control the levels of bilirubin in their blood.
2. A teenager with a rare blood disorder requires exchange transfusion to manage their condition.
3. An adult patient with liver disease undergoes exchange transfusion to improve their liver function.
4. A patient with sickle cell disease receives exchange transfusion to prevent complications and manage their symptoms.
5. A patient with autoimmune hemolytic anemia undergoes exchange transfusion to treat their condition.
6. A young child with a genetic disorder requires exchange transfusion to maintain their overall health.
7. An elderly patient with a history of blood disorders undergoes exchange transfusion to improve their quality of life.
8. A patient with severe anemia receives exchange transfusion to increase their red blood cell count.
9. A pregnant woman with Rh incompatibility undergoes exchange transfusion to prevent complications for her and the fetus.
10. A patient with a rare metabolic disorder requires exchange transfusion to manage their condition and prevent organ damage.