HCPCS code P9044 – Cryoprecipitate-reduced plasma

Key takeaways

HCPCS code P9044 reports plasma, cryoprecipitate reduced, billed per unit. It is the plasma left after cryoprecipitate is removed, often called cryo-poor plasma.

The product is low in fibrinogen, Factor VIII, Factor XIII, and von Willebrand factor. Its main use is plasma exchange or transfusion for TTP.

P9044 is not a platelet code. Leukocyte-reduced platelets are P9031 or P9035, and pathogen-reduced cryo-poor plasma is P9025.

Hospital outpatient departments are paid for P9044 under OPPS with status indicator R. The CY 2026 national rate is $132.05 per unit.

HCPCS code P9044: Definition and official descriptor

HCPCS code P9044 is the Level II code for plasma, cryoprecipitate reduced, each unit. It sits in the P9010-P9100 blood and blood products range of the CMS HCPCS Level II system. The product it describes is also called cryo-poor plasma or cryosupernatant plasma.

The billing unit is one bag of cryoprecipitate-reduced plasma, as issued by the blood bank. P9044 is billed by the hospital or facility that furnishes the product. Setting-specific rules come from your Medicare Administrative Contractor (MAC).

What is cryoprecipitate-reduced plasma?

Cryoprecipitate-reduced plasma is what remains after cryoprecipitate is taken out of fresh frozen plasma. The Circular of Information for the Use of Human Blood and Blood Components describes the process. FFP is thawed at 1 to 6 °C, and the cold-insoluble cryoprecipitate is removed by centrifugation.

The remaining supernatant plasma must be refrozen within 24 hours of thawing, at –18 °C or colder. It can come from whole-blood-derived plasma or from apheresis-collected plasma.

Removing the cryoprecipitate changes what the plasma can do. According to the Circular, the product looks like this.

• Reduced: fibrinogen, Factor VIII, Factor XIII, von Willebrand factor (vWF), and cryoglobulin. The largest vWF multimers drop sharply, while smaller multimers are retained.
• Retained: albumin, ADAMTS13, and Factors II, V, VII, IX, X, and XI, at levels close to the source plasma.

That profile explains its main use. Thrombotic thrombocytopenic purpura (TTP) involves a severe lack of ADAMTS13 activity, the enzyme that cleaves large vWF multimers. Cryo-poor plasma replaces ADAMTS13 while adding fewer of the large multimers.

The Circular lists transfusion or plasma exchange in patients with TTP as its indication. It may also supply other clotting factors when specific concentrates and other plasma products are not available.

It is contraindicated for replacing fibrinogen, vWF, Factor VIII, or Factor XIII. The Circular also says it should not be used as a substitute for FFP or other standard plasma.

What does P9044 cover and exclude?

P9044 covers one product: plasma from which the cryoprecipitate has been removed. Frozen units and units relabeled as Thawed Plasma Cryoprecipitate Reduced are the same product type, so both are reported with P9044.

These related products fall outside P9044 and take their own codes.

• Pathogen-reduced cryo-poor plasma is P9025, plasma, cryoprecipitate reduced, pathogen reduced, each unit. The processing line on the label decides between the two.
• Cryoprecipitate itself, the fibrinogen-rich fraction removed from the plasma, is P9012.
• Single-donor fresh frozen plasma frozen within 8 hours of collection is P9017. Plasma frozen between 8 and 24 hours is P9059.
• Pooled solvent/detergent plasma is P9023, and pathogen-reduced plasma is P9070 (pooled) or P9071 (single donor).
• Fresh frozen plasma from a retested donor is P9060.

Do not confuse P9044 with platelet codes. Leukocyte-reduced platelets are P9031 when whole-blood-derived and P9035 when collected by apheresis. A plasma line coded as platelets, or the reverse, fails a product-to-code check on audit.

Clinical procedure: How P9044 is used and documented

Cryo-poor plasma is usually given as replacement fluid during therapeutic plasma exchange for TTP. Each step of that workflow produces a record that supports the claim line.

1. Physician order. The order names cryoprecipitate-reduced plasma, the number of units or the exchange volume, and the indication. It must be on file before the blood bank releases the product.
2. Blood bank release. The transfusion service issues each bag and records the product code, unit number, issue time, and recipient. This record ties every billed unit to a specific bag.
3. Thawing and storage. The bag is thawed and either infused promptly or held at 1 to 6 °C until use. Units held past the first 24 hours are relabeled as Thawed Plasma Cryoprecipitate Reduced.
4. Plasma exchange or transfusion. The apheresis or nursing record shows start and stop times, volume replaced, vital signs, and any reaction. Each bag infused is one billable unit.
5. Monitoring. Platelet counts, LDH, and ADAMTS13 results track the response and support medical necessity for each further session.

How to bill HCPCS code P9044: Units, revenue codes, and wastage

Report one unit of service for each bag of cryoprecipitate-reduced plasma infused. If twelve bags are used in one plasma exchange, P9044 carries twelve units on that date of service.

Most hospitals buy blood from a supplier that charges only a processing fee. In that case, the AABB billing guide for blood products says to report the unit under revenue code 0390. Revenue code 038X, modifier BL, and the blood deductible apply only when the hospital charges for the blood itself.

The procedure goes on its own line. Therapeutic plasma exchange is reported with CPT 36514, and a simple transfusion with CPT 36430. Each is billed once per encounter, while P9044 carries the bag count.

AABB lists freezing and thawing as not separately billable with P9044, so do not add a thawing code to the claim. Unused units are never billed. If a thawed bag is not transfused, record it under your hospital’s blood wastage policy.

Medicare and payer reimbursement for P9044

Under the Medicare hospital outpatient prospective payment system (OPPS), P9044 carries status indicator R. That means blood and blood products paid separately, through APC 9522. The AABB summary of the CY 2026 OPPS final rule lists a national payment rate of $132.05 per unit.

That rate is down from $147.30 in 2025. Rates change every year, so check the CMS OPPS Addendum B for the quarter of service.

For inpatient stays, Medicare claims carry revenue codes rather than HCPCS codes, so the product is part of the inpatient payment. In a physician office, CMS sets no national rate for blood products, and payment varies by MAC.

The blood deductible does not apply to plasma

Medicare’s blood deductible covers the first three pints of blood a beneficiary receives each calendar year. It applies to whole blood and packed red cells, not to plasma.

A P9044 line is therefore not subject to the blood deductible. The standard Part B deductible and coinsurance apply to an outpatient P9044 line instead.

Commercial payers

Commercial coverage and prior authorization rules vary. Plasma exchange for TTP usually starts as an emergency, but later sessions can be scheduled. Confirm the payer’s policy for those planned sessions, and record any authorization number on the claim.

ICD-10 diagnosis codes that can support a P9044 claim

Every P9044 claim needs a diagnosis that establishes medical necessity. The attending physician owns the diagnosis, and the billing team checks that the claim matches the documented indication.

The table below is illustrative, built around the indications in the Circular of Information. It is not a coverage list, so check your MAC and payer policies for the codes they accept.

A diagnosis that points to fibrinogen, Factor VIII, Factor XIII, or vWF replacement contradicts the product. If that pairing appears, check whether cryoprecipitate (P9012) or another product was given instead.

Related HCPCS codes: P9044 vs P9025, P9012, P9017, P9023, and P9070

Among the Level II HCPCS codes, the plasma codes in the P9 range split on processing. Was the cryoprecipitate removed, was the plasma pathogen reduced or solvent/detergent treated, and when was it frozen? The map below walks a bag label to its code.

The most frequent miscoding here is billing cryo-poor plasma as FFP on P9017, or FFP as P9044. Another is missing the pathogen-reduction step that moves the unit to P9025. The product name on the bag label settles both.

Common claim denials for HCPCS code P9044 and how to avoid them

P9044 denials cluster around a few predictable errors. Our denial management process guide covers the general workflow: find the root cause, correct the record, and resubmit with support attached.

Documentation checklist for P9044 claims

This checklist maps each record to the denial it prevents. Review it before submitting a P9044 claim, especially for a series of exchanges. Good medical billing compliance starts with documentation, not with the remittance advice.

• Physician order. Dated before the blood bank release, naming cryoprecipitate-reduced plasma, the units or exchange volume, and the indication.
• Blood bank issue record. Shows the product name, unit numbers, issue times, and recipient. This is the primary audit document for code and unit checks.
• Apheresis or infusion record. Records start and stop times, volume replaced, patient response, and any reaction. Timestamps should align with the blood bank record.
• Diagnostic labs. Platelet count, LDH, schistocytes, or ADAMTS13 activity showing the TTP picture that justified the exchange.
• Follow-up labs. Results confirming the clinical response, which matter most for a series of exchanges.
• Wastage record. If a thawed bag was not transfused, the blood bank records the unit and the reason.
• Prior authorization number. Where a commercial payer requires it, the number appears on the claim and in the record.
• Patient consent. A signed consent for plasma exchange or transfusion, per facility policy and state law.

How Pabau keeps blood product claim lines traceable

Most billing teams check a plasma exchange claim by opening three systems: the blood bank log, the apheresis record, and the billing software. When a payer asks for support months later, someone rebuilds the trail by hand.

In Pabau’s billing software, clinical notes, charges, and invoices sit on one patient record. From that record, Pabau’s claim tracking software submits each claim and follows it through to payment or denial.

Your team still confirms the code, units, and diagnosis. Pabau keeps the notes and charges behind that decision on the same record.

The result is a shorter path from a payer’s records request to a complete response, because the documentation already sits next to the claim.

Keep blood product claims traceable with Pabau

Pabau keeps clinical documentation, charges, and claim status in one system. Billing teams can trace each P9044 line back to the record behind it, and spend less time rebuilding evidence for a payer review.

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Conclusion

P9044 is a narrow plasma code. It fits one product, the plasma left once cryoprecipitate is removed, and that product has one main job in plasma exchange for TTP. A claim that pairs it with that diagnosis and the right bag count is hard to dispute.

The errors come from neighbors: FFP on the wrong line, a missed pathogen-reduction step that belongs on P9025, or a platelet code mixed in. To see how Pabau keeps the documentation and the claim in one place, book a demo.

Continue your research

Need a framework for reducing claim rejections across your practice? Clean claim submission covers the elements every claim needs to pass payer edits before adjudication.

New to the revenue cycle behind a claim like this? What is medical billing explains the end-to-end revenue cycle from charge capture to payment posting.

Billing pathogen-reduced plasma instead? HCPCS code P9070 covers pooled pathogen-reduced plasma, which takes its own P-code.

Got a denial back on a blood product line? Denial codes in medical billing explains what the common denial codes mean and how to respond to them.

Frequently asked questions