How To Use CPT Code 38206

CPT 38206 describes the process of harvesting blood-derived hematopoietic progenitor cells (HPCs) for transplantation. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 38206?

CPT 38206 can be used to describe the procedure of harvesting hematopoietic progenitor cells (HPCs) from a patient’s own blood for transplantation. This code is used when a provider performs apheresis, a technique that separates the HPCs from other components of the blood using specialized equipment.

2. Official Description

The official description of CPT code 38206 is: ‘Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous.’

3. Procedure

1. The provider connects the patient’s blood circulation to a machine that performs apheresis.
2. The machine separates the hematopoietic progenitor cells (HPCs) from other components of the blood.
3. The provider may perform multiple cycles of apheresis to collect a sufficient amount of HPCs.
4. After collecting the cells, the provider transplants them into the patient’s body.
5. The remaining blood returns to the patient’s circulation.

4. Qualifying circumstances

CPT 38206 is used when a provider harvests hematopoietic progenitor cells (HPCs) from a patient’s own blood for transplantation. This procedure is typically performed to treat diseases of the blood and bone marrow, as well as certain types of cancer. The provider may also harvest stem cells from the bone marrow in addition to the blood. The harvesting of blood-derived HPCs is similar to a normal blood donation and does not require extensive provider intervention.

5. When to use CPT code 38206

CPT code 38206 should be used when a provider performs the procedure of harvesting blood-derived hematopoietic progenitor cells (HPCs) for autologous transplantation. This code is not used for harvesting HPCs from another person’s blood.

6. Documentation requirements

To support a claim for CPT 38206, the provider must document the following information:

• Reason for the procedure and the need for hematopoietic progenitor cell transplantation
• Details of the apheresis procedure, including the number of cycles performed
• Amount of hematopoietic progenitor cells (HPCs) collected
• Date and time of the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 38206, ensure that the procedure involves the harvesting of blood-derived hematopoietic progenitor cells (HPCs) for autologous transplantation. This code should not be reported for the harvesting of HPCs from another person’s blood. It is important to follow any additional guidelines provided by the payer or specific coding instructions for accurate billing.

8. Historical information

CPT 38206 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 performing apheresis to harvest hematopoietic progenitor cells (HPCs) from a patient’s blood for autologous transplantation.
2. A patient undergoing the procedure of harvesting blood-derived HPCs for autologous transplantation to treat a blood disorder.
3. A provider collecting HPCs from a patient’s blood using apheresis for subsequent autologous transplantation to treat leukemia.
4. A patient with lymphoma undergoing the procedure of harvesting blood-derived HPCs for autologous transplantation as part of their treatment plan.
5. A provider performing apheresis to collect HPCs from a patient’s blood for autologous transplantation to treat multiple myeloma.
6. A patient with a bone marrow disorder undergoing the procedure of harvesting blood-derived HPCs for autologous transplantation.
7. A provider performing apheresis to collect HPCs from a patient’s blood for autologous transplantation to treat a genetic blood disorder.
8. A patient with a relapsed cancer undergoing the procedure of harvesting blood-derived HPCs for autologous transplantation as part of their treatment regimen.
9. A provider collecting HPCs from a patient’s blood using apheresis for subsequent autologous transplantation to treat a non-Hodgkin lymphoma.
10. A patient with a myelodysplastic syndrome undergoing the procedure of harvesting blood-derived HPCs for autologous transplantation.