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injection vs transfusion

  1. Question injection vs transfusion
    Medical Coding Books
    Hi My name is Ginny, When a person has a paracentensis and they develope a lack of Albumin in their blood system (albumin is a blood serum, a blood componet) and the Doctor replenishes the Albumin by injection (sometimes up to 60 min or more) . What is the correct CPT code. 36430--Transfusion, blood or blood componets or 96365 -- Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or durg); initial up to 1 hour . We have the 3M system and it brings me to the code 36430, which I agree is the correct code, but I'm told to use 96365. Does 96365 include blood and blood componets? thank you .

  2. #2
    Hi Ginny:

    What is the infusion code for albumin? 36430 or 96365?

    I would suggest this to be reported as an infusion (96365). According to notes in the HCPCS code book, as of 07/01/05 albumin is not considered a blood product under OPPS.

  3. Default injection vs transfusion of Albumin
    Hi. The definition of Serum Albumin is , The most abundant protein in human blood. It is produced by the liver and balances the water content of blood. A protein that is important in maintaing blood volume. Albumin is a blood componet.

  4. #4
    Albumin is administered as a therapeutic infusion, not as a transfusion. The policies and procedures of infusion and transfusion differ so for billing purposes I can understand reporting 96365 as suggested by qhr.

  5. Default
    Per Coding Clinic for HCPCS, 1Q 2010, page 7: albumin is a blood derivative (not a blood product such as platelets, plasma, etc) and should be reported with 96365.

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