Summary & Overview
CPT 36430: Venous Catheter Placement for Blood Transfusion
CPT code 36430 denotes the puncture of a vein with catheter placement to transfuse blood or blood components directly into the bloodstream. This procedure is a common vascular access technique used across acute care settings to enable transfusion when peripheral or central access is required. Nationally, accurate use and reporting of this code affect clinical documentation, hospital workflow, and payer reimbursement for transfusion-related access procedures.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical context, the typical sites where the service is delivered, and the payer landscape covered. The publication also summarizes benchmarks and coding guidance where available, highlights policy considerations that affect coverage and billing, and explains how 36430 is used in service lines involving transfusion therapy.
This summary supports clinicians, billing professionals, and policy analysts seeking a national perspective on procedure classification and billing practices for venous catheter placement used specifically for transfusion of blood and blood components. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 36430 describes puncture of a vein and placement of a catheter to transfuse blood or blood components directly into the patient’s bloodstream. This procedure is an invasive vascular access service performed to deliver transfusions when intravenous access is required for administration of blood products.
-
Service type: Vascular access for transfusion
-
Typical site of service: Hospital inpatient or outpatient setting, emergency department, or other acute care facility where transfusion services are provided
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult inpatient or outpatient requiring transfusion of blood or blood components due to acute blood loss, symptomatic anemia, or coagulopathy. A 68-year-old patient admitted after gastrointestinal bleeding is hemodynamically stable after initial resuscitation but requires packed red blood cell transfusion. The interprofessional workflow includes the ordering clinician documenting indication and units required, informed consent per facility policy, blood bank crossmatch and product preparation, and a qualified clinician (hospitalist, emergency physician, hematologist, or certified registered nurse in infusion services) performing venous puncture and catheter placement for direct transfusion. Vital signs and transfusion reaction precautions are monitored before, during, and after the procedure. Documentation includes the indication, site and approach for venous access, catheter size, number of attempts, any immediate complications, blood product type and unit identifiers, and patient tolerance of transfusion.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service on the same day | When an E/M is performed and documented as distinct from the transfusion procedure on the same day. |
59 |