CPT® Code 36516

Therapeutic apheresis; with extracorporeal immunoadsorption, selective adsorption or selective filtration and plasma reinfusion

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—such as white blood cells, red blood cells, platelets, and plasma—based on their weight. The physician plays a critical role in evaluating the patient's condition and determining 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's body, which then enters the apheresis machine through one of the lumens of the catheter. 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 vital signs, including cardiac activity and oxygen saturation levels. Upon completion of the procedure, the patient is disconnected from the machine, and a re-evaluation is conducted to assess the patient's condition. In the context of CPT® Code 36516, therapeutic apheresis specifically targets the removal of certain blood constituents, such as antibodies, proteins, or lipids, using techniques like extracorporeal immunoadsorption, selective adsorption, or selective filtration, followed by the reinfusion of plasma. This targeted approach allows for the effective treatment of conditions where specific plasma components are implicated in the disease process.