tci Part B Insider - 2010 Issue 33

Reader Questions: Watch 36430 Units -- RACs Are

Question: If we give two units of blood, should we report 36430 twice? Answer: No. You should report 36430 (Transfusion, blood or blood components) only once. Support: CPT Assistant (March 2001) states you should report 36430 only once per transfusion regardless of how many units you administer. In addition, CMS's medically unlikely edits (MUEs) list a limit of 1 for 36430, meaning that's the maximum number of units the majority of patients should require. Beware: The RAC auditor for Region C, Connolly Healthcare, has listed blood transfusions as one of its approved issues. Specifically, the RAC will check that...

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