CPT® Code 36515

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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.