CPT 0342T: LDL Apheresis for Hypercholesterolemia
CPT code 0342T represents LDL apheresis — an extracorporeal blood filtration procedure that removes low density lipoprotein (LDL) cholesterol from a patient’s plasma and returns cellular components and filtered plasma. Nationally, this code matters as a specialized therapeutic intervention for patients with severe or refractory hypercholesterolemia for whom medication and standard treatments are insufficient. The procedure is resource-intensive, requires specialized equipment and trained staff, and is typically performed in outpatient apheresis or hospital-based infusion settings.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical intent and service context, typical sites of care, and which payers commonly encounter claims for this service. The publication also summarizes benchmarks and coverage considerations relevant to billing, utilization, and coding compliance for this high-cost, specialized therapy. Policy updates, coding guidance, and payer-specific coverage nuances are highlighted so readers can understand reimbursement and administrative implications at a national level.
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Billing Code Overview
CPT code 0342T describes a therapeutic apheresis procedure in which a provider draws the patient’s blood, selectively removes low density lipoprotein (LDL) cholesterol from the plasma, and returns the red blood cells and remaining filtered plasma to the patient. The procedure is performed specifically to treat hypercholesterolemia by lowering circulating LDL levels.
Service type: Therapeutic LDL apheresis (lipoprotein apheresis), a blood filtration therapy intended to remove LDL particles from plasma.
Typical site of service: Ambulatory infusion or apheresis center, hospital outpatient department, or specialized vascular procedure unit where extracorporeal blood filtration and monitoring are available.