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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.
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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:
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:
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 |
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| 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. |
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