How To Use CPT Code 38204

CPT 38204 describes the management of recipient hematopoietic progenitor cell donor search and cell acquisition. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 38204?

CPT 38204 can be used to describe the management of recipient hematopoietic progenitor cell donor search and cell acquisition. This code is used when a provider oversees the process of finding a suitable donor and acquiring hematopoietic progenitor cells (HPCs) that are compatible with the recipient.

2. Official Description

The official description of CPT code 38204 is: ‘Management of recipient hematopoietic progenitor cell donor search and cell acquisition.’

3. Procedure

1. The provider leads a team that reviews potential donors’ records and screens them for compatibility as bone marrow or stem cell donors.
2. The provider assesses sample cells from potential donors to determine compatibility.
3. The provider manages the plans to harvest the hematopoietic progenitor cells (HPCs) from compatible donors.
4. The provider oversees the process of acquiring the HPCs that are compatible with the recipient.
5. The provider ensures that the recipient receives the appropriate hematopoietic progenitor cells for their treatment.

4. Qualifying circumstances

CPT 38204 is used when a provider manages the search for a suitable donor and the acquisition of hematopoietic progenitor cells (HPCs) that are compatible with the recipient. The provider reviews potential donors’ records, screens them for compatibility, and manages the plans to harvest the cells. The provider may also assess sample cells from potential donors to determine compatibility.

5. When to use CPT code 38204

CPT code 38204 should be used when a provider is responsible for managing the search for a suitable donor and the acquisition of hematopoietic progenitor cells (HPCs) that are compatible with the recipient. This code is appropriate when the provider oversees the entire process, from reviewing potential donors’ records to ensuring the recipient receives the appropriate cells for their treatment.

6. Documentation requirements

To support a claim for CPT 38204, the provider must document the following information:

• Details of the recipient’s condition and the need for hematopoietic progenitor cell transplantation
• Documentation of the search for potential donors and the screening process for compatibility
• Plans for harvesting the hematopoietic progenitor cells (HPCs)
• Documentation of the acquisition process and confirmation of compatibility
• Details of the recipient’s treatment and the administration of the acquired cells
• Signature of the provider overseeing the management of the donor search and cell acquisition

7. Billing guidelines

When billing for CPT 38204, ensure that the provider is responsible for managing the search for a suitable donor and the acquisition of hematopoietic progenitor cells (HPCs). There are no specific guidelines regarding reporting CPT 38204 with other codes. However, it is important to accurately document and code all services provided during the process of hematopoietic progenitor cell transplantation.

8. Historical information

CPT 38204 was added to the Current Procedural Terminology system on January 1, 2003. There have been no updates to the code since its addition.

9. Examples

1. A provider overseeing the search for a suitable donor and the acquisition of hematopoietic progenitor cells (HPCs) for a patient with leukemia.
2. A provider managing the process of finding a compatible donor and acquiring HPCs for a patient in need of a bone marrow transplant.
3. A provider leading a team to review potential donors’ records and screen them for compatibility as stem cell donors for a patient with lymphoma.
4. A provider assessing sample cells from potential donors to determine compatibility and managing the plans to harvest the HPCs for a patient with multiple myeloma.
5. A provider overseeing the acquisition of HPCs that are compatible with the recipient for a patient undergoing hematopoietic progenitor cell transplantation.
6. A provider ensuring that the recipient receives the appropriate hematopoietic progenitor cells for their treatment after managing the search for a suitable donor and the acquisition process.
7. A provider managing the search for a compatible donor and the acquisition of HPCs for a patient with aplastic anemia.
8. A provider overseeing the process of finding a suitable donor and acquiring HPCs for a patient in need of a stem cell transplant.
9. A provider leading the team responsible for reviewing potential donors’ records and screening them for compatibility as bone marrow donors for a patient with myelodysplastic syndrome.
10. A provider assessing sample cells from potential donors to determine compatibility and managing the plans to harvest the HPCs for a patient with sickle cell disease.