How To Use CPT Code 36514

CPT 36514 describes the therapeutic apheresis procedure, specifically for plasma pheresis. 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 36514?

CPT 36514 is used to report the therapeutic apheresis procedure for plasma pheresis. This procedure involves the removal of plasma, which is the liquid portion of blood that suspends the blood cells. The remaining components, such as red blood cells, platelets, and white blood cells, are returned to the patient. Therapeutic apheresis is commonly used to treat various blood disorders and can be performed as an adjunct to stem-cell transplant treatment.

2. Official Description

The official description of CPT code 36514 is: ‘Therapeutic apheresis; for plasma pheresis.’

3. Procedure

1. The patient is prepared for the therapeutic apheresis procedure under sterile conditions.
2. The patient’s blood is connected to an extracorporeal machine that separates out specific components.
3. In the case of plasma pheresis, the machine removes the plasma while returning the red blood cells, platelets, and white blood cells to the patient.
4. During the procedure, the patient may receive an IV infusion, such as D5W, to maintain volume.

4. Qualifying circumstances

CPT 36514 is used when therapeutic apheresis is performed specifically for plasma pheresis. This procedure is indicated for patients with blood disorders such as leukemia, sickle-cell anemia, hemophilia, immune disorders, hyperglobulinemia, and hypercholesterolemia. It is important to note that therapeutic apheresis should be performed by a qualified healthcare professional with expertise in this procedure.

5. When to use CPT code 36514

CPT code 36514 should be used when reporting the therapeutic apheresis procedure for plasma pheresis. It is important to ensure that the procedure performed aligns with the specific requirements of this code. If the procedure involves the removal of other blood components, such as white blood cells or red blood cells, different codes should be used.

6. Documentation requirements

To support a claim for CPT 36514, the healthcare professional must document the following information:

• Indication for therapeutic apheresis and the specific need for plasma pheresis
• Date and duration of the procedure
• Details of the procedure, including the equipment used and any IV infusions administered
• Any complications or adverse reactions during the procedure
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT 36514, it is important to ensure that the procedure performed aligns with the specific requirements of this code. Therapeutic apheresis procedures involving the removal of other blood components should be reported with different codes. It is also important to follow any additional guidelines provided by payers regarding documentation and medical necessity.

8. Historical information

CPT 36514 was added to the Current Procedural Terminology system on January 1, 2003. There have been no updates to the code since its addition.

9. Examples

1. A patient with hypercholesterolemia undergoing therapeutic apheresis for plasma pheresis to reduce their cholesterol levels.
2. A patient with immune disorders receiving therapeutic apheresis for plasma pheresis to remove excess antibodies from their blood.
3. A patient with sickle-cell anemia undergoing therapeutic apheresis for plasma pheresis to manage their symptoms and improve their overall health.
4. A patient with hyperglobulinemia receiving therapeutic apheresis for plasma pheresis to reduce the levels of immunoglobulins in their blood.
5. A patient undergoing stem-cell transplant treatment receiving therapeutic apheresis for plasma pheresis as an adjunct therapy to support the transplant process.