About this policy
CMS National Coverage Determination | ncd_id=144 | manual_section=110.5 | coverage_level_code=1 | national_coverage_type=True | under_review=False | lab_ncd=False
Coverage indications
Granulocyte transfusions to patients suffering from severe infection and granulocytopenia are a covered service under Medicare. Granulocytopenia is usually identified as fewer than 500 granulocytes/mm 3 whole blood. Accepted indications for granulocyte transfusions include: Granulocytopenia with evidence of gram negative sepsis; and Granulocytopenia in febrile patients with local progressive infections unresponsive to appropriate antibiotic therapy, thought to be due to gram negative organisms.
Documentation requirements
Benefit Categories: 35 - Inpatient Hospital Services; 46 - Outpatient Hospital Services Incident to a Physician's Service; 52 - Physicians' Services
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
Backwork has no codes on record for this policy. Check the source.