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The CPT® Code 36430 refers to the procedure of transfusion, specifically involving blood or blood components. Blood and its components, which include whole blood, platelets, packed red blood cells, and plasma products, play a critical role in various medical treatments. Transfusions are typically performed to replace blood that has been lost or depleted due to several factors, including injuries, surgical procedures, conditions such as sickle cell disease, or treatments for malignant neoplasms. The primary purpose of administering red blood cells is to enhance the quantity of blood cells responsible for transporting oxygen and nutrients throughout the body. Platelets are transfused to help control bleeding and improve the blood's clotting ability, while plasma is used to restore total blood volume and provide essential blood factors that aid in clotting. The procedure begins with the preparation of the skin over the designated transfusion site, followed by the insertion of an intravenous line. Prior to the transfusion, any medications prescribed by the physician are administered. During the transfusion process, the patient is closely monitored for any signs of adverse reactions, ensuring safety and efficacy throughout the procedure.
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The transfusion of blood or blood components is indicated in various clinical scenarios where there is a need to restore blood volume or improve blood function. The following conditions may warrant the performance of this procedure:
The procedure for blood transfusion involves several critical steps to ensure safety and effectiveness. Each step is designed to prepare the patient and facilitate the transfusion process.
After the transfusion is completed, the patient continues to be monitored for a period to ensure that no delayed reactions occur. This includes checking vital signs and observing for any symptoms that may indicate an adverse reaction to the transfused blood. Documentation of the transfusion, including the type and amount of blood product administered, the patient's response, and any reactions observed, is essential for medical records. Additionally, the healthcare team may provide instructions for follow-up care, which could include monitoring for signs of complications or scheduling further evaluations as needed.
| Short Descr | TRANSFUSION BLD/BLD COMPNT | Medium Descr | TRANSFUSION BLOOD/BLOOD COMPONENTS | Long Descr | Transfusion, blood or blood components | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 5 - Incident To Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Not Discounted when Multiple | ASC Payment Indicator | Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 222 - Blood transfusion |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | AG | Primary physician | FS | Split (or shared) evaluation and management visit | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | RT | Right side (used to identify procedures performed on the right side of the body) | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2024-01-01 | Changed | Short Description changed. |
| Pre-1990 | Added | Code added. |
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