The blood deductible applies only to whole blood or packed red cells. Other components
of blood such as platelets, fibrinogen, plasma, gamma globulin, and serum albumin
are not subject to the blood deductible. These components of blood are covered biologicals.
The term whole blood means human blood from which none of the liquid or cellular components
has been removed. Where packed red cells are furnished, a unit of packed red cells
is considered equivalent to a pint of whole blood.
The blood deductible involves only the charges for the blood or packed red cells.
Charges for the administration of blood or packed cells are not subject to the blood
deductible. Accordingly, although payment may not be made for the first three pints
of blood and/or units of packed red cells furnished to a beneficiary in a calendar
year, payment may be made (subject to the cash deductible) for the administration
charges for all covered pints or units including the first three furnished in a calendar
The blood deductible applies only to the first three pints and/or units furnished
in a calendar year, even though more than one physician or clinic furnished blood.
Furthermore, to count toward the deductible, the blood must be covered with respect
to all applicable criteria (i.e., it must be medically necessary, it must be furnished
incident to a physician's services, etc.).