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Anesthesia Coding Alert

You Be the Coder:

Ask Carrier About Isovolemic Hemodilution

Published on Tue Feb 08, 2005

Question: Our anesthesiologist performed isovolemic hemodilution during a radical prostatectomy. How should I code this?

New Jersey Subscriber

Answer: Isovolemic hemodilution is the process of withdrawing the patient's own blood during surgery and later retransfusing it. The anesthesiologist usually removes the blood after the patient is asleep, so you can include the time as part of the anesthesia service.

Some physicians don't bill for hemodilution because they believe that charging for it along with anesthesia could cause problems. Other physicians do charge separately for the hemodilution, so talk with your physicians and the carrier to decide how best to handle the claim.

If you do charge for the hemodilution, carriers might approve any of several codes: 86890 (Autologous blood or component, collection processing and storage; predeposited), 86891 (... intra- or postoperative salvage), 36430 (Transfusion, blood or blood components), and 99195 (Phlebotomy, therapeutic [separate procedure]).
 
Report diagnosis code V59.01 (Autotransfusion of whole blood).
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