CPT® Code 86932

1. Indications

The procedure associated with CPT® Code 86932 is indicated for the preservation of red blood cells for future transfusion needs. The following conditions may warrant the use of this procedure:

• Blood Storage: To store blood units for later use, ensuring availability for patients requiring transfusions.
• Emergency Transfusions: In situations where immediate access to blood products is necessary, frozen blood can be thawed and prepared quickly.
• Planned Surgical Procedures: For patients undergoing surgeries that may require blood transfusions, pre-stored frozen blood can be prepared in advance.

2. Procedure

The procedure for CPT® Code 86932 involves several critical steps to ensure the safe freezing and thawing of blood units:

• Step 1: Blood Collection - Blood is obtained from a donor through a separately reportable procedure. This initial step is crucial as it provides the raw material needed for the subsequent processes.
• Step 2: Preparation of Blood Unit - The collected blood undergoes preparation where serum or plasma is separated from the red blood cells. This separation is essential for the preservation of the red blood cells.
• Step 3: Glycerolization - The red blood cells are mixed with a glycerol-based cryoprotectant. This preservative penetrates the outer membrane of the red cells, displacing water inside the cells to prevent ice crystal formation during freezing.
• Step 4: Freezing - The blood unit is then frozen at temperatures of -122.8 °F or lower. This step is critical to ensure the long-term viability of the red blood cells.
• Step 5: Thawing - When the blood is needed, the frozen unit is thawed by placing it in a water bath set at 98.6°F (37°C) for approximately 30 minutes. This controlled thawing process is vital to maintain cell integrity.
• Step 6: Deglycerolization - After thawing, the red blood cells are washed with a series of progressively dilute sodium solutions to remove the glycerol preservative, white blood cell fragments, and plasma. This step ensures that the blood is safe for transfusion.
• Step 7: Storage of Thawed Unit - The thawed and deglycerolized blood unit can be stored at temperatures between 1-6°C for up to 24 hours, allowing for flexibility in transfusion timing.
• Step 8: Refreezing (if necessary) - If the thawed blood is not needed for transfusion, it may be refrozen, provided that a rejuvenation chemical is added to the unit prior to refreezing. This step allows for the potential reuse of the blood unit.

3. Post-Procedure

Post-procedure care for the blood units involves monitoring the storage conditions to ensure that the thawed blood remains at the appropriate temperature of 1-6°C if not immediately transfused. It is essential to adhere to the 24-hour limit for the storage of thawed units to maintain their viability. Additionally, if the blood unit is not used and is to be refrozen, the addition of a rejuvenation chemical must be performed prior to refreezing to ensure the red blood cells remain functional. Proper documentation of the entire process, including the times of freezing, thawing, and any chemical additions, is crucial for compliance and traceability in blood transfusion practices.