Summary & Overview
HCPCS Level II P9055: Apheresis Platelets, Leukocyte-Reduced, CMV-Negative
HCPCS Level II code P9055 designates a single unit of apheresis/pheresis platelets that are leukocyte-reduced and cytomegalovirus (CMV) negative. This code captures specialized blood product supply used for transfusion in patients at risk for transfusion-transmitted leukocyte or CMV complications. Nationally, accurate coding for these modified platelet units supports appropriate billing, inventory tracking, and clinical communication across hospitals, blood centers, and outpatient infusion sites.
Key payers commonly involved in coverage discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for P9055, typical sites of service where the product is used, and the role of this code in claims and billing workflows. The publication also outlines expected benchmarks and policy considerations relevant to blood-product coding and reimbursement, and highlights how P9055 interfaces with transfusion services and supply chain documentation.
This summary is intended for billing managers, clinical transfusion services, and payers seeking a national view of the code’s clinical purpose and billing implications. Data not available in the input.
Billing Code Overview
HCPCS Level II code P9055 represents platelets that are leukocyte-reduced and CMV-negative collected via apheresis/pheresis, billed per unit. The service involves the collection, processing, and provision of a single unit of apheresis-derived platelets that have undergone leukocyte reduction and are confirmed cytomegalovirus (CMV) negative.
Service Type: Blood product supply (apheresis/pheresis platelets)
Typical Site of Service: Hospital outpatient departments, hospital inpatient transfusion services, blood banks, and ambulatory infusion or transfusion centers
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Clinical & Coding Specifications
Clinical Context
A 62-year-old female with chemotherapy-induced thrombocytopenia and active mucosal bleeding is admitted to the hospital for platelet transfusion. The transfusion service requests P9055 — platelet units that are leukocyte-reduced and cytomegalovirus (CMV) negative, collected by apheresis. Indications include platelet count typically <10,000/µL without bleeding, or higher thresholds (e.g., <20,000–50,000/µL) with fever, sepsis, active bleeding, or planned invasive procedures. The clinical workflow begins with an order in the electronic medical record specifying product attributes (leukocyte reduced, CMV-negative, apheresis). Pre-transfusion testing includes current type and screen, pre‑transfusion platelet count, and review of transfusion history for alloimmunization or transfusion reactions. The blood bank issues a labeled apheresis platelet unit meeting the P9055 specifications; bedside nursing completes patient identification, baseline vital signs, and informed consent per facility policy; the unit is transfused over 30–60 minutes while monitoring for transfusion reactions. Post-transfusion platelet count and clinical assessment are performed to determine response. Typical sites of service are hospital inpatient, hospital outpatient infusion center, and ambulatory surgical centers when transfusion is required for perioperative management.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
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