Blood

10.1.4 - Blood (Rev. 18, Issued: 03-04-05, Effective: 07-01-05, Implementation: 07-05-05) This section is a further explanation of §10.1.1. A provider may charge the beneficiary (or other person on his or her behalf) only for the first three pints of blood or units of packed red cells furnished during the calendar year. The charges may not exceed the provider's customary charges. The provider may not charge for any whole blood or packed red cells in any of the following circumstances: • The provider obtained the blood or red cells at no charge other than a processing or service charge; • The blood or packed red cells have been replaced; or • The provider (or its blood supplier) receives from an individual, or a blood bank, a replacement offer. This offer is applicable if the replacement blood would not endanger the health of a recipient and if the prospective donor's health would not be endangered by making a blood donation. In this case the provider is precluded from charging even if it or its blood supplier rejects the replacement offer. • Refer to Pub. 100-04, Medicare Claims Processing Manual, chapter 4, §231 regarding billing for blood and blood products under the Hospital Outpatient Prospective Payment System (OPPS).