Coding Ahead
CasePilot
Medical Coding Assistant
Case2Code
Search and Code Lookup Tool
CareerCenter
Medical Coding Job Board
Log in Register free account

Need help choosing the right code?

Ask CasePilot about procedures, modifiers, bundling, and coding guidance.

Try CasePilot
Code deleted, see 36516.

Official Description

Therapeutic apheresis; with extracorporeal immunoadsorption and plasma reinfusion

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

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—white blood cells, red blood cells, platelets, and plasma—based on their weight. The physician plays a critical role in evaluating the patient to determine the necessity for plasmapheresis, which is often performed through a dual lumen, dialysis-type catheter. During the procedure, the physician establishes the parameters for plasmapheresis and programs the machine accordingly. The initiation of plasmapheresis involves the extraction of blood from the patient, which is then directed into the apheresis machine through one of the catheter's lumens. While the machine may be operated by the physician, it is common for a nurse to manage the operation while the physician monitors the patient's condition, which may include cardiac monitoring and pulse oximetry. Upon completion of the procedure, the patient is disconnected from the machine and undergoes a re-evaluation. In the context of CPT® Code 36515, therapeutic apheresis specifically targets the removal of certain antibodies or proteins from the blood using a method known as extracorporeal immunoadsorption, followed by plasma reinfusion. This technique involves the separation of the patient's plasma from other blood components, with the plasma being treated through an affinity column designed to adsorb only the specific antibody or protein responsible for the disease state. The remaining plasma constituents are then returned to the patient's body, ensuring that only the targeted elements are removed. This procedure is distinct from other forms of therapeutic apheresis, such as those described in CPT® Codes 36514 and 36516, which focus on different components and methods of separation.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure of therapeutic apheresis with extracorporeal immunoadsorption and plasma reinfusion is indicated for various conditions where specific antibodies or proteins are contributing to a disease state. The following are explicitly provided indications for this procedure:

  • Autoimmune Disorders Conditions where the immune system mistakenly attacks the body's own tissues, often requiring the removal of harmful antibodies.
  • Neurological Disorders Certain neurological conditions that may be exacerbated by specific antibodies, necessitating their removal to alleviate symptoms.
  • Hematological Disorders Blood disorders where abnormal proteins or antibodies are present, which can be targeted and removed through this procedure.
  • Transplant Rejection Situations where the body is producing antibodies against transplanted organs or tissues, requiring intervention to prevent rejection.

2. Procedure

The procedure of therapeutic apheresis with extracorporeal immunoadsorption and plasma reinfusion involves several critical steps that ensure the effective removal of specific antibodies or proteins from the patient's blood. The following procedural steps are outlined:

  • Step 1: Patient Evaluation The physician conducts a thorough evaluation of the patient to determine the necessity for therapeutic apheresis. This includes assessing the patient's medical history, current condition, and specific indications for the procedure.
  • Step 2: Catheter Placement A dual lumen, dialysis-type catheter is inserted into the patient, typically in a large vein, to facilitate the removal and return of blood during the procedure. This catheter allows for the separation of blood components while maintaining circulation.
  • Step 3: Machine Setup The physician programs the apheresis machine according to the established parameters for the procedure. This includes setting the flow rates and determining the duration of the apheresis process.
  • Step 4: Initiation of Apheresis Blood is drawn from the patient through one lumen of the catheter and enters the apheresis machine. The machine separates the blood into its components, allowing for the targeted removal of plasma.
  • Step 5: Immunoadsorption Process The separated plasma is passed through an affinity column within the apheresis machine. This column is designed to adsorb specific antibodies or proteins that are contributing to the patient's disease state, while allowing other plasma constituents to pass through and be returned to the patient.
  • Step 6: Plasma Reinjection After the immunoadsorption process, the remaining plasma constituents are reinfused back into the patient through the second lumen of the catheter, ensuring that the patient retains necessary blood components while the targeted antibodies or proteins have been removed.
  • Step 7: Monitoring and Completion Throughout the procedure, the physician monitors the patient's vital signs and overall condition. Once the apheresis is complete, the patient is disconnected from the machine, and a re-evaluation is performed to assess the patient's response to the treatment.

3. Post-Procedure

After the completion of therapeutic apheresis with extracorporeal immunoadsorption and plasma reinfusion, the patient may require specific post-procedure care. This includes monitoring for any immediate adverse reactions or complications that may arise from the procedure. The physician will typically assess the patient's vital signs and overall condition to ensure stability. Patients may also be advised to hydrate adequately and may need follow-up appointments to evaluate the effectiveness of the treatment and to determine if additional sessions are necessary. It is essential to provide the patient with information regarding potential side effects and signs of complications that should prompt immediate medical attention.

Short Descr APHERESIS ADSORP/REINFUSE
Medium Descr THER APHERESIS W/XTRCORP IMMUNODSPTJ& PLSM RENFJ
Long Descr Therapeutic apheresis; with extracorporeal immunoadsorption and plasma reinfusion
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Procedure or Service, Not Discounted when Multiple
Type of Service (TOS) 1 - Medical Care
Berenson-Eggers TOS (BETOS) P6C - Minor procedures - other (Medicare fee schedule)
MUE Not applicable/unspecified.
CCS Clinical Classification 231 - Other therapeutic procedures
Date
Action
Notes
2017-12-31 Deleted Code deleted, see 36516.
2013-01-01 Changed Medium Descriptor changed.
2011-01-01 Changed Short description changed.
2003-01-01 Added First appearance in code book in 2003.
Code
Description
Code
Description
Code
Description
Code
Description
CasePilot

Get instant expert-level medical coding assistance.

Ask about:
CPT Codes Guidelines Modifiers Crosswalks NCCI Edits Compliance Medicare Coverage
Example: "What is CPT code 99213?" or "Guidelines for E/M services"