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Therapeutic apheresis is a medical procedure that utilizes a specialized blood processing machine to selectively remove plasma or specific plasma constituents that are contributing to a patient's disease state. This process involves the separation of blood into its various components—such as white blood cells, red blood cells, platelets, and plasma—based on their weight. The physician plays a critical role in evaluating the patient's condition and determining the necessity for plasmapheresis, which is often performed through a dual lumen, dialysis-type catheter. During the procedure, the physician establishes the parameters for plasmapheresis and programs the machine accordingly. The initiation of plasmapheresis involves the extraction of blood from the patient's body, which then enters the apheresis machine through one of the lumens of the catheter. While the machine may be operated by the physician, it is common for a nurse to manage the operation while the physician monitors the patient's vital signs, including cardiac activity and oxygen saturation levels. Upon completion of the procedure, the patient is disconnected from the machine, and a re-evaluation is conducted to assess the patient's condition. In the context of CPT® Code 36516, therapeutic apheresis specifically targets the removal of certain blood constituents, such as antibodies, proteins, or lipids, using techniques like extracorporeal immunoadsorption, selective adsorption, or selective filtration, followed by the reinfusion of plasma. This targeted approach allows for the effective treatment of conditions where specific plasma components are implicated in the disease process.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure of therapeutic apheresis, specifically under CPT® Code 36516, is indicated for various medical conditions where the removal of specific blood constituents is necessary to manage or treat the disease state. The following are the explicitly provided indications for this procedure:
The procedure for therapeutic apheresis under CPT® Code 36516 involves several critical steps to ensure the effective removal of targeted blood constituents. The following procedural steps are outlined:
After the completion of therapeutic apheresis under CPT® Code 36516, the patient may require specific post-procedure care to ensure a smooth recovery. This includes monitoring for any immediate adverse reactions to the procedure, such as changes in vital signs or symptoms of discomfort. The physician may provide instructions regarding hydration and any necessary follow-up appointments to assess the effectiveness of the treatment. Additionally, the patient may need to be monitored for potential complications related to the catheter insertion site, such as infection or bleeding. It is essential for the healthcare team to communicate with the patient about any signs or symptoms that should prompt immediate medical attention following the procedure.
| Short Descr | APHERESIS IMMUNOADS SLCTV | Medium Descr | THER APHERESIS W/EXTRACORPOREAL IMMUNOADSORPTION | Long Descr | Therapeutic apheresis; with extracorporeal immunoadsorption, selective adsorption or selective filtration and plasma reinfusion | 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 | 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) | 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 | 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). | 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. | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | 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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| 2018-01-01 | Changed | Long, medium and short descriptions changed. |
| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2011-01-01 | Changed | Short description changed. |
| 2003-01-01 | Added | First appearance in code book in 2003. |
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