US · guidance
CMS Pub. 100-04, ch. 4, § 231.5
Billing for Irradiation of Blood Products
In situations where a beneficiary receives a medically reasonable and necessary
transfusion of an irradiated blood product, an OPPS provider may bill the specific
HCPCS code which describes the irradiated product, if a specific code exists, in addition
to the CPT code for the transfusion. If a specific HCPCS code for the irradiated blood
product does not exist, then the OPPS provider should bill the appropriate HCPCS code
for the blood product, along with CPT code 86945 (irradiation of blood product, each
unit).
EXAMPLE: If an OPPS provider transfuses the product described by P9040 (red blood
cells, leukocytes reduced, irradiated, each unit), it would not be appropriate to bill an
additional CPT code for irradiation of the blood product since charges for irradiation
should be included in the charge for P9040.
History
(Rev. 496, Issued: 03-04-05, Effective: 07-01-05, Implementation: 07-05-05)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
37bb715736f23b79a240ad9940c2f13a7f6072877ac82f738cccbf48412bea5d
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