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CMS Granulocyte Transfusions Form
This procedure is not covered
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/mm3 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.