Coding & Billing Information for Pathogen-Reduced Platelet and Plasma Products Administered in the Hospital Outpatient Setting

The Centers for Medicare & Medicaid Services (CMS) has established Healthcare Common Procedure Coding System (HCPCS) Level II codes for hospital outpatient billing of INTERCEPT Platelets and Plasma.

HCPCS Code	Long Descriptor	Effective Date
P9070	Plasma, pooled, multiple donor, pathogen reduced, frozen, each unit	1/1/2016
P9071	Plasma (single donor), pathogen reduced, frozen, each unit	1/1/2016
P9073	Platelets, pheresis, pathogen reduced, each unit	1/1/2018

Effective 1/1/2018, HCPCS P9073 replaces HCPCS Q9988 to bill pathogen reduced apheresis platelets. HCPCS Q9988 is inactive effective 1/1/2018.

Standard billing practices apply to transfusion procedures used to administer pathogen reduced, psoralen-treated INTERCEPT platelet and plasma products administered in the outpatient treatment setting.

Standard billing practices apply to INTERCEPT platelet and plasma products administered in the hospital inpatient treatment setting.

 

References:

Hospital Outpatient Prospective Payment – Final Rule with Comment Period and Final CY2018 Payment Rates:
https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalOutpatientPPS/Hospital-Outpatient-Regulations-and-Notices-Items/CMS-1678-FC.html

The information provided here is for informational purposes only and may be subject to change.  Always check with individual third party payers to verify their requirements for billing these products and associated transfusion services.