2025 CPT code 36513
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Therapeutic apheresis for platelet removal.
Modifiers may apply depending on the circumstances of the procedure, such as location (e.g., modifier -26 for professional component only), multiple procedures (e.g., modifier -51), or other qualifying factors.
The procedure must be medically necessary to treat the patient's condition, with proper documentation justifying the need for therapeutic apheresis.The indication for the procedure should be clearly documented.
The physician's responsibility includes patient preparation, performing the apheresis procedure (including establishing vascular access and monitoring), and post-procedure care directly related to the apheresis.
In simple words: This medical code describes a procedure where a machine separates the blood into its parts, removes platelets (tiny blood cells that help with clotting), and returns the rest of the blood to the patient. This is done to treat a medical condition.
This CPT code, 36513, represents therapeutic apheresis specifically for the removal of platelets from a patient's blood.The procedure involves using specialized equipment to separate blood components, removing platelets, and returning the remaining blood constituents to the patient. This is a therapeutic intervention, distinct from plateletpheresis for donor purposes.The procedure includes all necessary steps, from establishing vascular access to post-procedure monitoring related to the apheresis itself.
Example 1: A patient with severe thrombocytopenia (low platelet count) due to autoimmune disease undergoes therapeutic plateletpheresis to increase their platelet count and reduce bleeding risk., A patient with thrombotic thrombocytopenic purpura (TTP), a life-threatening condition characterized by excessive platelet clotting, undergoes therapeutic apheresis to remove excess platelets and improve organ perfusion., A patient with essential thrombocythemia (ET), a myeloproliferative disorder causing abnormally high platelet counts, undergoes therapeutic apheresis to reduce their platelet count and minimize the risk of thrombosis.
Detailed patient history, including diagnosis and symptoms necessitating the procedure; complete blood counts (CBC) with differential before and after the procedure; documentation of the apheresis procedure, including the volume of blood processed, the quantity of platelets removed, and any complications; and post-procedure monitoring notes and results of any relevant lab tests.The medical necessity for the procedure must be clearly documented.
** This code is specifically for therapeutic apheresis to remove platelets. It is distinct from plateletpheresis for donor purposes. Always verify the code's appropriateness based on the specific clinical circumstances and ensure proper documentation is present.
- Revenue Code: P6C (Medicare Fee Schedule: MINOR PROCEDURES - OTHER)
- RVU: Information not available in provided source.Refer to the CMS website for current RVU values and reimbursement information.
- Global Days: Information not provided.The global period would depend on the specific circumstances and may be 0, 10, or 90 days post-procedure. Consult additional billing guidelines.
- Payment Status: Active
- Modifier TC rule: Modifier -TC (Technical Component) would not typically be used, as the code inherently includes professional and technical components.
- Fee Schedule: Information not available in provided data. Check CMS fee schedules for historical data.
- Specialties:Hematology, Oncology, Immunology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center