Laboratory Question for the Week of January 15, 2024

Question:

How does CMS advise hospitals to bill for blood products with frozen HCPCS codes, emphasizing that the transfused unit should not be administered frozen? Additionally, what clarification does CMS provide regarding billing for freezing or thawing, and how is reimbursement for thawing handled according to CMS guidelines?

Answer:

When a blood product HCPCS code reflects that the product was frozen, it is understood that the unit cannot be administered in the frozen state. For this reason, CMS instructs the hospital to bill the appropriate P-code for the product that was transfused but not to bill a separate freezing or thawing CPT code. CMS has clarified that reimbursement for the thawing of the unit is included in the APC for the P-code.

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