Summary & Overview
HCPCS P9036: Platelets, Pheresis, Irradiated, Each Unit
HCPCS Level II code P9036 denotes a unit of pheresis-derived platelets that has been irradiated prior to transfusion. This blood product code matters nationally because irradiated pheresis platelets are used in specific clinical circumstances — including immunocompromised patients and those at risk for transfusion-associated graft-versus-host disease — and represent a distinct chargeable supply in inpatient and outpatient transfusion services. Payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn the clinical context for use of P9036, typical sites of service where the product is billed, and how benchmarks and payer policy can affect coverage and payment for irradiated pheresis platelet units. The summary covers expected billing scenarios, common modifiers listed for reporting supply and service details, and where to find policy guidance. Data not available in the input will be noted where applicable.
Billing Code Overview
HCPCS Level II code P9036 represents Platelets, pheresis, irradiated, each unit. This code describes a transfusion blood product unit that has been collected by pheresis and treated with irradiation to reduce the risk of transfusion-associated graft-versus-host disease.
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Service type: Blood product transfusion (irradiated pheresis platelets)
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Typical site of service: Hospital inpatient facility, hospital outpatient infusion center, or transfusion center where blood products are administered to patients.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with acute myeloid leukemia admitted to the hematology/oncology inpatient unit develops severe thrombocytopenia (platelet count <10,000/µL) with mucosal bleeding. The treatment plan by the attending hematologist includes transfusion of irradiated apheresis platelets to reduce transfusion-associated graft-versus-host disease risk. Blood bank staff issue one unit of P9036 (Platelets, pheresis, irradiated, each unit), documenting unit identifiers, irradiation date/time, and compatibility testing. The transfusion is performed in the inpatient bed or procedure room with vital signs monitoring by nursing staff; transfusion reaction surveillance is conducted during and after the infusion. Billing for the product is submitted using HCPCS Level II code P9036 with any applicable modifier(s) reflecting institutional or clinical circumstances. Typical sites of service include inpatient hospital units, outpatient oncology infusion centers, and hospital-based transfusion services. Typical patient scenarios include hematologic malignancy with treatment-induced thrombocytopenia, bone marrow transplant recipients, and patients with platelet function defects or active hemorrhage requiring platelet support.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier |