Summary & Overview
CPT 86960: Technical Plasma Removal (Apheresis) Procedure
CPT code 86960 denotes a technical laboratory procedure to remove fluid—typically plasma—from blood or blood products. Nationally, this code captures a specialized extracorporeal technique used in therapeutic apheresis and related laboratory processing. Accurate coding for this service affects clinical documentation, billing workflows, and reimbursement pathways across hospital and outpatient settings.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for CPT code 86960, typical sites of service, and which stakeholders commonly manage or bill for the procedure. The publication also outlines the types of benchmarks and policy developments to watch—such as coverage policies, utilization trends, and required documentation standards—and highlights operational considerations for laboratories and apheresis programs.
This summary is intended for billing professionals, clinical program managers, and policy analysts seeking a national perspective on the code's clinical role, payer landscape, and the categories of information that influence reimbursement and compliance.
Billing Code Overview
CPT code 86960 describes a laboratory technical procedure in which fluid, typically plasma, is removed from blood or blood products. This service is a form of extracorporeal plasma removal performed by a lab analyst or trained technologist to separate and extract fluid components for therapeutic or preparative purposes.
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Service type: Therapeutic apheresis/technical plasma removal procedure
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Typical site of service: Hospital laboratory, outpatient infusion center, or specialized apheresis unit
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with autoimmune-associated thrombocytopenia and symptomatic hyperviscosity is admitted to an outpatient apheresis unit for therapeutic plasma exchange. The patient arrives with laboratory orders and an apheresis prescription from a hematologist. Vascular access is confirmed — either a central venous catheter placed by interventional radiology or peripheral large-bore venous access — and baseline vital signs and coagulation studies are obtained. The laboratory analyst operates the apheresis instrument, which performs the technical procedure to remove plasma from the patient's blood, collects the separated plasma into collection bags, and returns cellular components with replacement fluid per protocol. Quality control, procedural documentation of volumes removed and replacement infused, and labeling of specimens for laboratory testing are completed. The procedure is performed in an ambulatory infusion/apheresis suite or hospital outpatient department, with clinical oversight by the ordering physician.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician professional component for supervision or interpretation related to the procedure (rare for apheresis technical code). |
TC |