Question

A 48-year-old female patient has breast carcinoma and presents to the hospital outpatient unit complaining of low energy. The physician orders hemoglobin and hemocrit counts, which were performed.

After evaluation, it is determined the patient has anemia in neoplastic disease. The physician orders 3 units of packed red blood cells, which are transfused on the unit.

Which coding is best for the blood products? (See the HCPCS options below.)

HCPCS Code	Descriptor
P9010	Whole blood for transfusion, per unit
P9021	Red blood cells for transfusion, per unit
P9060	Fresh frozen plasma for transfusion, per unit, donor retested
P9615	Catheterization for collection of specimen
P9045	Infusion, albumin, 5%, 250 ml

	A.	P9021
	B.	P9021 X 3
	C.	P9045, P9060
	D.	P9010 X 3, P9615

A resident of a SNF is seen in outpatient surgery for treatment of her dysphagia due to CVA. An EGD with PEG tube insertion was performed and the patient was discharged back to the nursing home.

Which procedural coding should the hospital report for this service?

	A.	43246
	B.	43761
	C.	43752
	D.	43235, 43653

Answer 1

A. P9021 Is inappropriate as it denotes only red blood cell products.

B.P9021 x 3 is more appropriate as it describes the no.of red blood cell unit transfused. Hence option B is correct.

C. It describes the albumin and FFP. So it is incorrect.

D. It is also inappropriate because it describes whole blood and no specimen was collected

A.43246

A. The surgeon is placing PEG tube through esophagogastroduodenoscopy. PEG tube was placed initially. So the code 43246 is more appropriate.

B. 43761 is used for repositioning of the tube. Hence it is inappropriate.

C. 43752 is used for NG tube placement. So it is also not appropriate.

D. 43235 denotes EGD and 43635 is add-on code used in case of biopsy. Hence it is incorrect.