CommercialBilling CodesHigh impact
Hospital Outpatient Billing Update: Blood Transfusion Services
HMSA·Hematology, Critical Care·Coding
Effective date
Dec 1, 2026
We identified it
Oct 4, 2026
Summary
Effective Dec. 1, 2026, HMSA commercial plans require blood and blood products to be billed with Revenue Code 038X plus applicable HCPCS codes, while blood processing and storage services must use Revenue Code 039X. This is a coding requirement change for hospital outpatient blood transfusion services.
Action Required
By November 30, 2026: Billing team must update hospital outpatient billing system to enforce new revenue code requirements for HMSA commercial plans. Specifically: (1) Configure billing rules to require Revenue Code 038X for all blood and blood product charges paired with the applicable HCPCS code; (2) Configure billing rules to require Revenue Code 039X for blood processing and storage services; (3) Test claims submission in staging environment before go-live; (4) Train billing staff on the new coding structure; (5) Review current blood transfusion billing to identify any claims that will require retroactive adjustment. Consult the Blood Transfusion Services and Enhanced Code Editing for Blood and Blood Product Charges pages on the HMSA Provider Resource Center for detailed guidance on applicable HCPCS codes. Claims submitted with incorrect revenue codes after Dec. 1, 2026 will be subject to denial or rework.