How To Use CPT Code 0540T

CPT 0540T describes the administration of chimeric antigen receptor T-cell (CAR-T) therapy, specifically the intravenous infusion of genetically modified T cells extracted from a patient’s own blood. 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 0540T?

CPT 0540T can be used to report the administration of CAR-T therapy, which involves the intravenous infusion of genetically modified T cells that have been extracted from the patient’s own blood. This therapy is used to treat leukemia and other types of blood cancer.

2. Official Description

The official description of CPT code 0540T is: ‘Chimeric antigen receptor T-cell (CAR-T) therapy; CAR-T cell administration, autologous.’

3. Procedure

1. The patient undergoes chemotherapy, such as cyclophosphamide and fludarabine, to deplete lymphocytes in preparation for CAR-T therapy.
2. The healthcare provider explains the procedure to the patient and obtains informed consent.
3. Prior to the administration of CAR-T therapy, the patient receives acetaminophen and an H1-antihistamine.
4. The healthcare provider sterilizes the skin over the puncture site and inserts a needle into the vein.
5. A catheter tubing connected to a bag containing the genetically modified CAR-T cells is attached to the needle.
6. The healthcare provider opens the valve, allowing the CAR-T cell solution to flow into the patient’s vein.
7. The administration involves a single intravenous infusion of CAR-T cells, with the dosage based on the patient’s body weight and the specific condition being treated.

4. Qualifying circumstances

CPT 0540T is used for patients who have previously received chemotherapy and are now eligible for CAR-T therapy. It is indicated for the treatment of refractory or relapsed acute lymphoblastic leukemia (ALL) in pediatric and young adult patients up to 25 years of age. It is also used for refractory large B-cell lymphoma.

5. When to use CPT code 0540T

CPT code 0540T should be used when reporting the administration of CAR-T therapy, specifically the intravenous infusion of genetically modified T cells. It is important to ensure that the therapy is being administered to eligible patients and for the appropriate indications.

6. Documentation requirements

To support a claim for CPT 0540T, the healthcare provider must document the following information:

• Patient’s diagnosis and eligibility for CAR-T therapy
• Details of the procedure, including the dosage administered
• Date and time of the administration
• Any pre-medication provided to the patient
• Signature of the healthcare provider administering the therapy

7. Billing guidelines

When billing for CPT 0540T, ensure that the administration of CAR-T therapy is accurately documented and meets the necessary criteria. It is important to follow the specific guidelines provided by the payer and to report any additional codes or modifiers as required. It is also important to note that there are specific HCPCS codes for the supply of the CAR-T therapy drugs, which should be reported separately.

8. Historical information

CPT code 0540T was added to the Current Procedural Terminology system on January 1, 2019. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider administers CAR-T therapy to a pediatric patient with refractory acute lymphoblastic leukemia.
2. A patient with relapsed large B-cell lymphoma receives CAR-T therapy as part of their treatment plan.
3. A healthcare provider administers CAR-T therapy to a young adult patient with refractory acute lymphoblastic leukemia.
4. A patient with relapsed acute lymphoblastic leukemia undergoes CAR-T therapy as a treatment option.
5. A healthcare provider administers CAR-T therapy to a pediatric patient with refractory large B-cell lymphoma.
6. A young adult patient with relapsed acute lymphoblastic leukemia receives CAR-T therapy as part of their treatment regimen.
7. A healthcare provider administers CAR-T therapy to a pediatric patient with refractory large B-cell lymphoma.
8. A patient with relapsed acute lymphoblastic leukemia undergoes CAR-T therapy as a treatment option.
9. A healthcare provider administers CAR-T therapy to a young adult patient with refractory acute lymphoblastic leukemia.
10. A patient with relapsed large B-cell lymphoma receives CAR-T therapy as part of their treatment plan.