Pathology/Lab Coding Alert

Outdated CPT descriptors kept coders scratching their heads when reporting apheresis procedures. Not any more, because CPT 2003 updates the entire code family to reflect current clinical practice. CPT Codes 2003 replaces two vague therapeutic apheresis codes with a family of six new codes that accurately and specifically list the various components performed. The new codes break the apheresis procedure into "a number of elements that may or may not be used in a specific patient since the different types of apheresis involve different amounts of work and technique," according to CPT Changes 2003, An Insider's View.

The deleted codes are 36520 (Therapeutic apheresis; plasma and/or cell exchange) and 36521 ( with extracor-poreal affinity column adsorption and plasma reinfusion). Apheresis is the process of extracting a patient's blood, removing certain factors and returning the blood to the patient. The new codes describe procedures that may be used to treat blood-disorder complications such as leukemia, sickle-cell anemia, hemophilia, immune disorders and hypercholesterolemia, as well as an adjunct to stem-cell transplant treatment:   36511 Therapeutic apheresis; for white blood cells     36512 for red blood cells     36513 for platelets     36514 for plasma pheresis     36515 with extracorporeal immunoadsorption and plasma reinfusion     36516 with extracorporeal selective adsorption or selective filtration and plasma reinfusion.   The new, more specific codes will allow accurate reporting of actual work performed for each patient. They also allow more accurate procedure tracking, which may impact future pricing because some of the codes involve using expensive, disposable apheresis columns.