CPT 36460 Intrauterine Fetal Transfusion Reimbursement | OpenPayer

Summary & Overview

CPT 36460: Intrauterine Fetal Transfusion via Umbilical Vein

CPT code 36460 represents an intrauterine fetal transfusion performed by delivering blood through the fetal umbilical vein while the fetus remains in utero. This highly specialized, invasive procedure addresses fetal anemia and related perinatal hematologic emergencies and has implications for maternal-fetal medicine bundles, neonatal outcomes, and acute-care resource utilization across tertiary hospitals nationally. It is clinically significant due to its role in preventing fetal hydrops, stillbirth, and severe neonatal morbidity when timely performed.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of care, and the service type. The publication also outlines common billing and coding considerations, typical modifiers observed in practice (input provided), and national-level benchmark concepts where available. Where input data is incomplete, the text notes that specific items are not available.

This summary equips healthcare administrators, maternal-fetal medicine clinicians, and coding professionals with clear context for CPT code 36460, informing claims filing, payer discussions, and care pathway documentation without offering clinical recommendations.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare36460CPTfetal transfusionintrauterine procedurematernal-fetal medicineperinatal carehospital servicesneonatal transfusion

Billing Code Overview

CPT code 36460 describes a procedure in which a provider performs a fetal transfusion via the umbilical vein while the fetus remains in utero. This service is an intrauterine fetal transfusion, typically performed to treat fetal anemia or alloimmunization-related conditions.

Service type: Invasive fetal therapeutic transfusion
Typical site of service: Hospital operating room or labor and delivery suite with maternal-fetal medicine and neonatal support

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient scenario involves a pregnant patient in the second or third trimester presenting with fetal anemia diagnosed by middle cerebral artery Doppler surveillance, abnormal nonstress test, hydrops fetalis, or known alloimmunization (for example, maternal anti-D). After fetal anemia is confirmed by ultrasound assessment and laboratory correlation, maternal-fetal medicine specialists coordinate an intrauterine transfusion. In the operating/procedure suite or high-acuity obstetric unit, with continuous fetal monitoring and ultrasound guidance, the provider performs a percutaneous umbilical vein transfusion (intrauterine fetal transfusion) by placing a needle through the maternal abdomen and uterine wall into the fetal umbilical vein and transfusing packed red blood cells. The clinical workflow includes preprocedure maternal consent and Rh/antibody review, fetal ultrasound localization, hematologic preparation of matched irradiated, CMV-negative blood, intraprocedural ultrasound-guided venous access and transfusion, monitoring for fetal bradycardia or bleeding, and postprocedure observation with follow-up Doppler and possible repeat transfusion scheduling.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when reporting only the physician's professional component separate from technical resources (rare for this bundled procedure).

CPT 36420: Infant Venous Access Incision for Blood Collection or Injection

CPT-36406-PEDIATRIC-PERIPHERAL-VENOUS-ACCESS-UNDER-3-YEARS

CPT 36406: Pediatric Peripheral Venous Access, Under 3 Years

CPT-36430-VENOUS-CATHETER-PLACEMENT-FOR-TRANSFUSION

CPT 36430: Venous Catheter Placement for Blood Transfusion

CPT-36440-PEDIATRIC-RAPID-BLOOD-TRANSFUSION-INFANT

CPT 36440: Rapid Pediatric Blood Transfusion for Infants

CPT-36415-VENIPUNCTURE-BLOOD-COLLECTION

CPT 36415: Venipuncture for Blood Collection

CPT-36400-VENIPUNCTURE-VENOUS-BLOOD-COLLECTION

CPT 36400: Venipuncture for Venous Blood Collection

CPT-36405-SCALP-VEIN-VENIPUNCTURE-IN-INFANTS

CPT 36405: Scalp Vein Venipuncture for Patients Under Three Years

CPT-36456-NEWBORN-VOLUME-REPLACEMENT-BLOOD-PLASMA-CRYSTALLOID

CPT 36456: Volume Replacement with Blood, Plasma, or Crystalloid

CPT-36450-EXCHANGE-TRANSFUSION-NEWBORN-UMBILICAL-VENOUS

CPT 36450: Neonatal Exchange Transfusion via Umbilical Vessel

CPT-36410-VENIPUNCTURE-BLOOD-DRAW-OR-INFUSION-AGE-3-PLUS

CPT 36410: Venipuncture for Blood Draw or Infusion, Age 3+

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Taxonomy Code	Specialty	Notes
207P00000X	Maternal-Fetal Medicine	Subspecialists who most commonly perform intrauterine fetal transfusion.
207L00000X	Obstetrics & Gynecology	General OB/GYNs with procedural experience in high-risk centers.
2080P0207X	Pediatric Hematology-Oncology	Consults for selection and preparation of blood products and anemia management.
207RH0000X	Reproductive Endocrinology/Infertility	Occasionally involved in complex congenital or alloimmune cases (consultative).
207K00000X	Family Medicine	May be involved in community triage and transfer coordination (support role).

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`O36.0121`	Maternal care for known or suspected fetal anemia, first trimester	Maternal-fetal care code used when fetal anemia is diagnosed and intrauterine transfusion is planned or performed.
`O36.0122`	Maternal care for known or suspected fetal anemia, second trimester	Common timing for intrauterine transfusion due to detected fetal anemia.
`O36.0123`	Maternal care for known or suspected fetal anemia, third trimester	Indicates late-gestation fetal anemia management and possible transfusion.
`P61.2`	Neonatal isoimmune hemolytic disease	Reflects fetal anemia due to maternal antibodies; intrauterine transfusion may be indicated.
`P55.0`	Hemolytic disease of newborn due to rhesus isoimmunization	Classic indication for intrauterine fetal transfusion when alloimmunization causes severe fetal anemia.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36460`	Transfusion, intrauterine, fetal intravascular (umbilical vessel)	Primary procedure described; direct treatment for fetal anemia.
`76937`	Ultrasound guidance for vascular access requiring imaging documentation	Often used for the real-time ultrasound guidance component during umbilical vein access.
`36591`	Blood transfusion, intra-arterial; each additional transfusion (list separately in conjunction with primary transfusion code if applicable)	May be reported for transfusion-related vascular access or additional transfusion sessions per payer rules.
`36556`	Collection of blood from a peripheral or central line (noting venous catheter placement)	Related to vascular access and line management for transfusion preparation in some workflows.
`99024`	Postoperative follow-up visit, global period services (note: use per payer policy)	Used to report postprocedure evaluation during the global period when applicable.

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