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Therapeutic apheresis is a medical procedure that utilizes a specialized blood processing machine to separate blood into its various components, which include white blood cells, red blood cells, platelets, and plasma. This separation is achieved based on the weight of the different blood components. The primary purpose of therapeutic apheresis is to remove a specific component of the blood that is contributing to a disease state, thereby alleviating the patient's condition. Prior to the procedure, a physician conducts a thorough evaluation of the patient to determine the necessity for therapeutic apheresis. The procedure typically involves the use of a previously placed central venous catheter, or alternatively, venous catheters may be inserted to facilitate the connection of blood tubing to the apheresis machine. The physician is responsible for determining the specific parameters for the apheresis process and programming the machine accordingly. Once initiated, blood is drawn from the patient and enters the apheresis machine through one of the venous catheters. The machine then separates the blood into its components, removes the targeted component that is causing the disease, and returns the remaining blood components back to the patient's body through a second catheter. Throughout the procedure, the physician closely monitors the patient, which may include cardiac monitoring and pulse oximetry to ensure patient safety. After the procedure is completed, the patient is disconnected from the machine and undergoes a re-evaluation to assess their condition.
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The indications for performing therapeutic apheresis for red blood cells include the following:
The procedure for therapeutic apheresis for red blood cells involves several critical steps:
After the therapeutic apheresis procedure, patients may require monitoring for any immediate side effects or complications. It is essential to assess the patient's vital signs and overall condition to ensure stability. Patients may experience mild side effects such as dizziness or fatigue, which should be addressed promptly. Follow-up evaluations may be necessary to determine the effectiveness of the procedure and to plan any further treatment if required. Additionally, the physician may provide specific post-procedure care instructions, including hydration and activity restrictions, to support the patient's recovery.
| Short Descr | APHERESIS RBC | Medium Descr | THERAPEUTIC APHERESIS RED BLOOD CELLS | Long Descr | Therapeutic apheresis; for red blood cells | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard 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 | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 231 - Other therapeutic procedures |
| GC | This service has been performed in part by a resident under the direction of a teaching physician | CR | Catastrophe/disaster related | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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. | AG | Primary physician | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | FS | Split (or shared) evaluation and management visit | GW | Service not related to the hospice patient's terminal condition | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study |
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| 2021-01-01 | Note | Guidelines changed. |
| 2003-01-01 | Added | First appearance in code book in 2003. |
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