HCPCS code P9038 — Rbc irradiated.
Status: Active.
Effective Jan 1, 2001.
Source: CMS HCPCS Level II.
P9038
ActiveRbc irradiated
Red blood cells, irradiated, each unit
Category:
Pathology & Lab
Section:
P-codes: Pathology and Laboratory
Effective:
Jan 1, 2001
Code type:
alphanumeric
OPPS Status:
R
— Blood and blood products
OPPS APC:
9505
MUE — Medically Unlikely Edits
Maximum units of P9038 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.
| Service Type | Max Units / Day |
|---|---|
| Outpatient Hospital | 4 |
| Practitioner Services | 2 |
Source: CMS Medicare NCCI Medically Unlikely Edits
NCCI Edits
The following codes cannot be billed together with P9038 without appropriate documentation.
| Column 2 Code | Modifier |
|---|---|
| P9010 | Modifier may bypass edit |
| P9011 | Modifier may bypass edit |
| P9016 | Modifier may bypass edit |
| P9019 | Modifier may bypass edit |
| P9020 | Modifier may bypass edit |
| P9021 | Modifier may bypass edit |
| P9022 | Modifier may bypass edit |
| P9031 | Modifier may bypass edit |
| P9034 | Modifier may bypass edit |
| P9035 | Modifier may bypass edit |
| P9039 | Modifier may bypass edit |
| P9073 | Modifier may bypass edit |
Source: CMS National Correct Coding Initiative (NCCI)