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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