How To Use CPT Code 36522

CPT 36522 describes the medical procedure known as extracorporeal photopheresis, which involves exposing a patient’s white blood cells to a drug called 8-methoxypsoralen (8-MOP) and then to ultraviolet A (UVA) light. 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 36522?

CPT 36522 is used to describe the medical procedure of extracorporeal photopheresis. This procedure involves the removal of a patient’s blood, isolation of the white blood cells, exposure of these cells to 8-methoxypsoralen (8-MOP), and subsequent exposure to ultraviolet A (UVA) light. The treated white blood cells are then re-infused back into the patient.

2. Official Description

The official description of CPT code 36522 is: ‘Photopheresis, extracorporeal.’

3. Procedure

1. The provider begins by removing the patient’s blood.
2. The blood is then centrifuged to isolate the white blood cells.
3. 8-methoxypsoralen (8-MOP) may be administered directly to the white blood cells after removal or to the patient before withdrawal of the white blood cells.
4. The treated white blood cells are exposed to ultraviolet A (UVA) light.
5. The provider re-infuses the treated white blood cells back into the patient.

4. Qualifying circumstances

CPT 36522 is used for patients who require extracorporeal photopheresis as a treatment. This procedure may be used for cutaneous variants of T-cell lymphoma, certain autoimmune disorders, and various complications related to organ transplants. It is important to check with the payer to determine which diagnostic codes make this procedure eligible for coverage.

5. When to use CPT code 36522

CPT code 36522 should be used when performing extracorporeal photopheresis as a medical procedure. It is important to ensure that the procedure meets the specific requirements outlined in the official description.

6. Documentation requirements

To support a claim for CPT 36522, the provider must document the following information:

• Indication for the procedure
• Details of the procedure performed, including the use of 8-methoxypsoralen (8-MOP) and ultraviolet A (UVA) light
• Date of the procedure
• Start and end times of the procedure
• Any additional relevant information or findings

7. Billing guidelines

When billing for CPT 36522, it is important to follow the specific guidelines provided by the payer. It is also important to consider if CPT code 36522 should be reported with any other codes. Additionally, it may be necessary to report the collection of the specimen separately, so it is advisable to check with the payer to avoid any denials or delays in payment.

8. Historical information

CPT 36522 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A patient with cutaneous T-cell lymphoma undergoing extracorporeal photopheresis to treat their condition.
2. An individual with an autoimmune disorder receiving extracorporeal photopheresis as a therapeutic intervention.
3. A patient experiencing complications after an organ transplant undergoing extracorporeal photopheresis to manage these complications.
4. An individual with a specific type of T-cell lymphoma unresponsive to other therapies receiving extracorporeal photopheresis as a treatment option.
5. A patient with a history of organ transplant experiencing graft-versus-host disease receiving extracorporeal photopheresis to address this complication.
6. An individual with a cutaneous variant of T-cell lymphoma that has not responded to other treatments undergoing extracorporeal photopheresis as a potential solution.
7. A patient with an autoimmune disorder that has not improved with conventional therapies receiving extracorporeal photopheresis as an alternative treatment option.
8. An individual experiencing complications after a bone marrow transplant undergoing extracorporeal photopheresis to manage these complications.
9. A patient with a specific type of T-cell lymphoma that has relapsed after previous treatments receiving extracorporeal photopheresis as a potential treatment option.
10. An individual with an autoimmune disorder that has not responded to other interventions undergoing extracorporeal photopheresis as a therapeutic approach.