Summary & Overview
HCPCS Level II P9058: Leukocyte-Reduced, CMV-Negative, Irradiated Red Blood Cell Unit
HCPCS Level II code P9058 represents a specialized red blood cell unit that is leukocyte reduced, cytomegalovirus (CMV) negative, and irradiated. This product is used in clinical situations where minimizing donor leukocytes, preventing CMV transmission, and eliminating viable lymphocytes are important for patient safety, such as in immunocompromised patients, neonates, and certain transplant recipients. Nationally, accurate coding for P9058 supports appropriate clinical documentation, blood bank workflows, and payer reimbursement for high-acuity transfusion services.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for this blood product, common places of service, and the relevance of precise HCPCS Level II coding. The publication provides benchmarks and policy-relevant details where available, highlights typical billing considerations for specialized blood components, and summarizes how payers commonly recognize and handle claims for irradiated, leukocyte-reduced, CMV-negative red blood cell units.
What readers will learn: the clinical indications for this blood product, typical sites of service, payer coverage landscape at a national level, and where to look for policy updates or billing clarifications. Data not available in the input is indicated where applicable.
Billing Code Overview
HCPCS Level II code P9058 describes red blood cells that are leukocyte reduced, CMV-negative, and irradiated, billed per unit. The service type is provision of a specialized blood product prepared to reduce leukocytes, prevent cytomegalovirus (CMV) transmission, and eliminate lymphocyte activity via irradiation. The typical site of service for this product is inpatient and outpatient hospital settings, transfusion centers, and other clinical locations where transfusion or blood component therapy is administered.
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Clinical & Coding Specifications
Clinical Context
A 62-year-old immunocompromised man with a history of allogeneic hematopoietic stem cell transplant is admitted for symptomatic anemia with hemoglobin 6.8 g/dL and symptomatic tachycardia. The transplant team orders replacement red blood cell transfusion. Because the patient is CMV-seronegative and at high risk for transfusion-transmitted CMV infection, and because he is immunocompromised and receiving frequent transfusions, the blood bank issues P9058 — red blood cells, leukocyte reduced, CMV-negative, irradiated, each unit. Units are irradiated to prevent transfusion-associated graft-versus-host disease and leukoreduced to reduce febrile nonhemolytic transfusion reactions and alloimmunization. The transfusion occurs in the inpatient hospital setting under direct supervision of the hematology team, with pretransfusion compatibility testing, patient identification verification, baseline vital signs, and transfusion monitoring per institutional policy. Documentation includes indication, unit numbers, product modifications (leukocyte reduced, cmv-negative, irradiated), informed consent, transfusion start and stop times, pre- and post-transfusion vitals, and any adverse reactions. Billing uses HCPCS Level II code P9058 for each unit transfused and may append relevant modifiers to indicate professional or facility circumstances and services rendered during the encounter.
Coding Specifications
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