How To Use CPT Code 0264T

CPT 0264T describes a procedure known as intramuscular autologous bone marrow cell therapy. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0264T?

CPT 0264T can be used to describe a specific procedure called intramuscular autologous bone marrow cell therapy. This procedure involves the preparation of harvested bone marrow cells and their injection into the muscles of the patient. It is commonly used to treat diseases like end stage peripheral artery disease.

2. Official Description

The official description of CPT code 0264T is: ‘Intramuscular autologous bone marrow cell therapy, with preparation of harvested cells, multiple injections, one leg, including ultrasound guidance, if performed; complete procedure excluding bone marrow harvest.’

3. Procedure

1. In this procedure, the provider prepares the already harvested bone marrow by centrifuging it at high speed to separate it into individual components.
2. The desired part of the bone marrow is collected and administered into the muscle, usually the gastrocnemius muscle, using ultrasound guidance.
3. This injection of bone marrow enhances the repair process and increases the diameter of existing arterial vessels.

4. Qualifying circumstances

This procedure is typically performed on patients with peripheral artery disease, a circulatory problem characterized by the narrowing of arteries in the limbs. The provider must harvest the bone marrow from the sternum, iliac crest, or ribs, and use it for intramuscular autologous bone marrow cell therapy. The patient must meet the specific criteria for this therapy.

5. When to use CPT code 0264T

CPT code 0264T should be used when the provider performs the complete procedure of intramuscular autologous bone marrow cell therapy, including the preparation of harvested cells and their injection into the muscle. If the provider only harvests the bone marrow for future use, a different code should be used.

6. Documentation requirements

To support a claim for CPT code 0264T, the provider must document the following information:

• Patient’s diagnosis and the need for intramuscular autologous bone marrow cell therapy
• Details of the bone marrow preparation process
• Date and time of the procedure
• Specific muscles injected with the bone marrow
• Use of ultrasound guidance, if performed

7. Billing guidelines

When billing for CPT code 0264T, ensure that the provider performs the complete procedure, including the preparation of harvested cells and their injection into the muscle. Do not report CPT code 0264T in conjunction with other specific codes. Consider the location of the testing and use appropriate modifiers if necessary.

8. Historical information

CPT code 0264T was added to the Current Procedural Terminology system on January 1, 2012. There have been no updates to the code since its addition.

9. Examples

1. A provider prepares harvested bone marrow cells and injects them into the gastrocnemius muscle of a patient with peripheral artery disease to enhance arterial vessel repair.
2. Using ultrasound guidance, a provider administers intramuscular autologous bone marrow cell therapy to a patient with end stage peripheral artery disease.
3. A provider performs the complete procedure of intramuscular autologous bone marrow cell therapy, including the preparation of harvested cells and their injection into the muscle, for a patient with peripheral artery disease.
4. Using a specific technique, a provider injects bone marrow cells into the muscle of a patient with peripheral artery disease to improve arterial vessel diameter.
5. A provider performs intramuscular autologous bone marrow cell therapy on a patient with peripheral artery disease, preparing harvested cells and injecting them into the muscle for enhanced repair.
6. Using ultrasound guidance, a provider administers intramuscular autologous bone marrow cell therapy to a patient with end stage peripheral artery disease.
7. A provider prepares harvested bone marrow cells and injects them into the gastrocnemius muscle of a patient with peripheral artery disease to enhance arterial vessel repair.
8. Using a specific technique, a provider injects bone marrow cells into the muscle of a patient with peripheral artery disease to improve arterial vessel diameter.
9. A provider performs the complete procedure of intramuscular autologous bone marrow cell therapy, including the preparation of harvested cells and their injection into the muscle, for a patient with peripheral artery disease.
10. Using ultrasound guidance, a provider administers intramuscular autologous bone marrow cell therapy to a patient with end stage peripheral artery disease.