Blood Transfusion

What it is

Whole blood is rarely given as such. It is separated into components — red cells, platelets, plasma, cryoprecipitate — and a patient is given the one they are short of. This code covers the transfusion service: hanging the unit, running it into a vein through an IV line, and monitoring the patient while it goes in. Three other things are typically billed alongside it and are not part of this code: the blood product, the laboratory work that types the patient's blood and cross-matches it against the unit, and the IV access if one had to be placed. Most donated blood comes from volunteer donors and is screened and tested for infections before release.

Why it is done

• To replace red cells lost to bleeding, whether from injury, surgery, or a slow internal loss
• To raise red cell counts in anemia that is not responding to, or cannot wait for, other treatment
• To give platelets or clotting factors to someone who is bleeding or at risk of bleeding because their blood will not clot properly
• To support patients whose marrow is not producing blood cells, including during chemotherapy

What to expect

Before the transfusion, blood is drawn to determine your type and check the unit against it, and identity is verified at the bedside — usually twice, by two people — because a mismatched unit is the most serious avoidable risk. The unit is then hung and run in through an IV. MedlinePlus gives a range of roughly one to four hours depending on how much is given. Vital signs are checked at the start and at intervals throughout, because a reaction, if one happens, usually declares itself early as fever, chills, itching, or breathlessness. Most transfusions pass without incident. You can normally read, eat, or sleep through it.

Questions worth asking

• Is each unit billed separately, and how many units are expected?
• Is the blood product itself a separate line from this transfusion service charge, and what is the price per unit?
• Are the type-and-screen and cross-match lab tests billed on their own, and by the hospital lab or an outside lab?
• If this is given in an outpatient infusion center rather than during an admission, is there a facility charge for the chair time as well?