Overview
CPT® Code 99195 is used to report therapeutic phlebotomy performed as a separate procedure. Therapeutic phlebotomy involves the removal of blood for medical purposes rather than diagnostic testing, typically to reduce iron overload, manage polycythemia vera, or treat other blood disorders.
This code represents the phlebotomy procedure itself, not any laboratory testing or evaluation performed on the collected blood.
Key Facts About CPT® 99195
- Service type: Therapeutic phlebotomy
- Provider type: Physicians, nurses, or qualified healthcare professionals
- Medical services included: Yes—blood removal for therapeutic purposes
- Specimen type: Whole blood
- Common clinical indications:
- Hemochromatosis or iron overload
- Polycythemia vera
- Erythrocytosis requiring blood volume reduction
- Symptomatic hyperviscosity
When to Use CPT® 99195
CPT 99195 is appropriate when:
- Therapeutic phlebotomy is performed as a standalone procedure
- The procedure is medically necessary for managing a patient’s blood disorder
- Blood removal is not performed solely for laboratory analysis
Examples:
- Removing 500 mL of blood from a patient with polycythemia vera to reduce hematocrit
- Performing routine therapeutic phlebotomy in a patient with hereditary hemochromatosis
Documentation Requirements
To properly support CPT 99195 billing, documentation should include:
- Patient identifiers and date of service
- Indication for therapeutic phlebotomy
- Volume of blood removed
- Technique used and any complications encountered
- Follow-up recommendations and monitoring plan
Accurate documentation ensures compliance, proper reimbursement, and safe patient care.
Reimbursement and Coding Considerations
- CPT 99195 is covered by most commercial insurers and Medicare when medically necessary
- Must be billed separately from diagnostic blood draws or lab tests
- Modifier use may be required if multiple therapeutic phlebotomy procedures are performed on the same day
- Always check payer-specific rules regarding frequency and coverage
How OptiMantra Supports Therapeutic Phlebotomy
OptiMantra’s integrated EMR and practice management system streamlines documentation, tracking, and billing for CPT 99195:
With OptiMantra, providers can:
- Record therapeutic phlebotomy directly in the patient chart
- Track procedure details, including blood volume and collection site
- Link phlebotomy procedures to care plans for blood disorder management
- Generate audit-ready, compliant billing codes
- Maintain longitudinal tracking for repeat therapeutic phlebotomy sessions
By centralizing phlebotomy workflows, OptiMantra helps practices maintain accurate records, ensure safe patient care, and optimize reimbursement.
Try OptiMantra for free here!
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