Apheresis:Plasma Exchange HELP!!!!

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The ouptatient infusion center that I work for has recently gained the Apheresis team. This means that I will be doing the billing for the Apheresis which I know very little about:confused: We are not sure that the hospital has been billing correctly for the Plasma exchanges and want to be sure that we do in order to get the maximum reimbursement. Looking at what information I have printed off 36514 is for Plasma Pheresis which is when they are removing the bad plasma from the patient. They then will use either Albumin or Fresh Frozen Plasma to be reinfused with the patients own blood after it has passed through and all the bad is removed. I am wondering if we should bill the 36514 for the removale than use another code for the reinfusion of the Albumin or FFP? I was looking at code 36516 for the reinfusion. So in a nut shell do we only use 36514 for the removing of the plasma and reinfusion? Or do we use a seperate code for the reinfusion? This has been my worst nightmare as i have no one here to really ask. I thank you in advance for any insight someone can give me:eek:
 

preserene

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Apheresis procedure ( = blood components separation ) consisting in plasma extracting :
- small volumes (600 ml max : plasmapheresis still used for plasma donation).
- large volumes ( 2 to 5 liters ): plasma exchange with volume balanced by replacement fluids used for treatment-called "Plasma Substitutes"- Replacement fluids.

[these plasma substitutes, should have :
- a prolonged volemic expanding potential
- no decay effects on hemostasis
- no infectious potential
- a moderate price ]

Colloidal solutes are prefered : modified gelatins, hydroxyethylstarch) in restricted volume ( 20 ml/kg) + completed by a 4% human albumin solution.

But Fresh frozen plasma is only indicated in case of major hemostasis disorders and thrombotic microangiopathy..


So, plasma extraction and plasma exchange with volume balanced fluid are the components of the main aspect of Aphresis- ie, Palsmapheresis, the exchange depending on the amount of Volume needed to be extracted.
So it is the same one code - 36514.

Sothen, when do we report the 36515 or 36516?: these are selective codes in Aphresis when fresh Plasma are infused--
When immunoadsorption/ selective adsorption and plasma reinfusion( fresh frozen plasma infusion) are used.

To be more simple these codes are used for more selective use of the real plama a whole product or fresh plasma reinfusion.
Hope this give a little more clarification
 
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Preserene

Thank you so much fir your help. can you also look at the note that my office Mgr sent me and give your advice on her question.


Apheresis w/ Fresh Frozen Plasma - 36514 for the plasma extraction and blood component separation (removing the bad plasma)

Then I wonder if we can bill 36430 code for the administration of the donor Fresh Frozen Plasma.

So maybe can ask; Is it appropriate to bill a blood component administration under 36430 for the Fresh Frozen Plasma that is given after a plasma pheresis or is the administration of the donor Fresh Frozen Plasma a component of the 36514 therapeutic apheresis code?
 
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i work at an infusion center, dr office pos, and we use the codes 36514 with P9045 when billing. my question is, is it covered by medicare part B in an office setting?
 
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