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2025 CPT code 36456

Partial exchange transfusion, blood, plasma, or crystalloid; newborn.

Follow CPT guidelines for surgical procedures. Ensure appropriate documentation supports medical necessity.

Modifiers may be applicable depending on the circumstances of the procedure. Consult the CPT manual for modifier guidelines.

Medical necessity for a partial exchange transfusion is established when the newborn has significant blood loss, hyperbilirubinemia, or other conditions that compromise cardiovascular stability or risk organ damage.Documentation must support the clinical need for the procedure.

The physician or qualified healthcare professional is responsible for accessing the umbilical vein, inserting and removing the catheter, administering the blood, plasma, or crystalloid solution, and managing any bleeding. They must also assess the newborn's condition and determine the appropriate volume of fluid to administer.

IMPORTANT:Do not report 36456 with 36430, 36440, 36450. Do not use modifier 63 with 36456.

In simple words: This code describes a procedure where a doctor or qualified healthcare professional gives a newborn baby blood, plasma, or a similar fluid to replace blood lost during surgery or to increase their blood volume if it's low.They do this by inserting a catheter into the umbilical vein and administering the fluid in several steps.

Partial exchange transfusion in a newborn infant, requiring the skill of a physician or other qualified healthcare professional, involving the administration of blood, plasma, or crystalloid solution to replace a volume of blood lost during surgery or to restore/maintain blood volume depleted from other causes.The procedure includes accessing the umbilical vein, inserting a catheter, introducing the replacement fluid in multiple cycles at varying intervals, removing the catheter, and controlling any bleeding.

Example 1: A premature infant with significant blood loss during surgery requires a partial exchange transfusion to restore blood volume and maintain hemodynamic stability. , A newborn with severe jaundice and hyperbilirubinemia undergoes a partial exchange transfusion to remove excess bilirubin and prevent kernicterus., An infant with a congenital heart defect and hypovolemic shock needs a partial exchange transfusion to support circulation until surgical intervention can be performed.

Detailed medical record documenting the indication for the exchange transfusion (e.g., blood loss, hyperbilirubinemia, hypovolemic shock), the type and amount of fluid administered, the method of administration, the patient's response to treatment, and any complications encountered.

** This procedure is performed by a physician or other qualified healthcare professional and involves the exchange of a portion of the infant's blood volume with blood, plasma, or crystalloid solution.Careful attention must be paid to fluid balance and electrolyte management. The physician's judgement is crucial in determining the indications, method, and extent of the transfusion.

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