Coding and Billing

reimbursement header

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
Q9988
Platelets, pheresis, pathogen reduced,
each unit
7/1/2017



HCPCS P9072 (Platelets, pheresis, pathogen reduced or rapid bacterial tested, each unit) is inactive effective 7/1/2017 and thereafter. Use HCPCS Q9988 to bill pathogen reduced apheresis platelets provided from 7/1/2017 through 12/31/2017.

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 CY2017 Payment Rates:
www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalOutpatientPPS/Hospital-Outpatient-Regulations-and-Notices-Items/CMS-1656-FC.htmlCMS-1656-FC.html

HCPCS Quarterly Update (click on “Other Codes Effective July 1, 2017”):
www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets/HCPCS-Quarterly-Update.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.

CONTACT US

   1 (855) 835-3523

   Cerus Corporation
   2550 Stanwell Dr
   Concord, CA 94520

MORE INFORMATION