2025 CPT code 36430
(Active) Effective Date: N/A Revision Date: N/A Surgical Procedures on Arteries and Veins - Venipuncture and Transfusion Procedures Surgery Feed
Transfusion of blood or blood components via venipuncture.
Modifiers may be applicable depending on the circumstances of the service.Consult the current CPT manual and payer-specific guidelines for modifier application.Examples of potential modifiers include 59 (distinct procedural service) if this service is distinct from another procedure performed on the same day, or modifiers related to reduced services or anesthesia.
Medical necessity for a blood transfusion is established when a patient's condition requires replacement of blood volume or blood components due to significant blood loss, anemia, or other clinical indications.Documentation must support the clinical need for transfusion based on the patient's condition, laboratory results, and overall assessment.
The physician or qualified healthcare professional is responsible for performing venipuncture, inserting the catheter, connecting the infusion set, and administering the blood or blood components.This also involves monitoring the patient for any adverse reactions during the transfusion process. Pre-transfusion and post-transfusion care are not typically included in this code.
- Surgery
- Surgical Procedures on the Cardiovascular System > Surgical Procedures on Arteries and Veins > Vascular Introduction and Injection Procedures > Venipuncture and Transfusion Procedures
In simple words: This code covers giving a blood transfusion. The doctor inserts a small tube into a vein to deliver blood or blood parts directly into the bloodstream.
This CPT code encompasses the procedure of administering blood or blood components (red blood cells, white blood cells, platelets, and plasma) into a patient's bloodstream via intravenous (IV) infusion.The process includes venipuncture to establish intravenous access, insertion of a catheter, and the subsequent infusion of the blood product.The code does not include pre-transfusion testing or post-transfusion monitoring. It is reported only once per transfusion regardless of the number of units administered.
Example 1: A patient with severe anemia receives a transfusion of packed red blood cells.CPT code 36430 is used to bill for the transfusion procedure., A trauma patient with significant blood loss is given a massive transfusion of whole blood and other blood components. CPT code 36430 is billed only once, regardless of the number of units transfused., A patient undergoing surgery experiences significant blood loss and requires intraoperative blood component transfusion. CPT code 36430 would be used to bill for the administration of these components.
Complete documentation must support medical necessity.This should include the patient's diagnosis, hemoglobin/hematocrit levels indicating anemia or blood loss, type and amount of blood or blood components administered, and any adverse reactions during or after the transfusion.Physician notes, laboratory reports, and transfusion records are required.
** The code 36430 only covers the administration of blood and blood components.Pre-transfusion testing, blood typing, crossmatching, and post-transfusion monitoring are billed separately using appropriate codes.
- Revenue Code: P6C (Minor Procedures - Other)
- RVU: This information is not available in the provided sources.Consult the current CPT codebook and relevant payer fee schedules for RVU data.
- Global Days: This information is not provided in the source, consult the current CPT manual for details.
- Payment Status: Active
- Modifier TC rule: Not applicable. This is not a procedure with a technical component.
- Fee Schedule: This information is not available in the provided sources. Consult the AMA CPT codebook and historical fee schedules for this data.
- Specialties:Hematology, Oncology, Surgery, Emergency Medicine, Anesthesiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center, Emergency Room - Hospital, Office