CPT® Code 36514

Therapeutic apheresis is a medical procedure that utilizes a specialized blood processing machine to selectively remove plasma or specific plasma constituents that are contributing to a patient's disease state. This process involves the separation of blood into its various components—namely white blood cells, red blood cells, platelets, and plasma—based on their weight. The procedure is initiated after a thorough evaluation by a physician, who determines the necessity for plasmapheresis based on the patient's condition. Typically, this procedure is performed using a dual lumen, dialysis-type catheter, which allows for the efficient removal and return of blood components. The physician is responsible for setting the parameters for the plasmapheresis and programming the machine accordingly. During the procedure, blood is drawn from the patient and enters the apheresis machine through one of the lumens of the catheter. The operation of the machine may be directly managed by the physician or delegated to a nurse, while the physician remains present to monitor the patient's vital signs, which may include cardiac monitoring and pulse oximetry. Upon completion of the procedure, the patient is disconnected from the machine, and a re-evaluation is conducted. In the context of CPT® Code 36514, the plasma is separated from the other blood components and collected in a designated bag, while the cellular components are returned to the patient along with a biologic replacement fluid, such as allogeneic plasma or human serum albumin, through the second lumen of the catheter. This procedure is distinct from CPT® Code 36516, which involves the removal of specific blood constituents, such as antibodies or proteins, using techniques like extracorporeal immunoadsorption or selective adsorption, followed by plasma reinfusion.