How To Use CPT Code 38230

CPT 38230 describes the procedure for bone marrow harvesting for transplantation, specifically allogeneic 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 38230?

CPT 38230 is used to describe the bone marrow harvesting procedure for allogeneic transplantation. In this procedure, a qualified healthcare provider inserts a long needle or trocar into the sternum or pelvic bone to extract a sufficient amount of bone marrow tissue from a donor for transplantation.

2. Official Description

The official description of CPT code 38230 is: ‘Bone marrow harvesting for transplantation; allogeneic.’

3. Procedure

1. The healthcare provider prepares the patient for the procedure, ensuring appropriate anesthesia and sterilization.
2. Using a specially designed needle or trocar, the provider inserts it through the skin, typically in the sternum or iliac crest.
3. The provider carefully pushes the needle into the bone marrow, confirming its position.
4. Once the needle is in place, the provider aspirates, scrapes, or excises the bone marrow tissue.
5. The extracted bone marrow tissue is then transferred to a container for transplantation.
6. After completing the procedure, the provider slowly removes the needle or trocar and applies pressure to control bleeding at the insertion site.

4. Qualifying circumstances

CPT 38230 is used for allogeneic transplantation, which involves using a tissue graft harvested from one person for another. The donor can be a cadaver or a living individual related or unrelated to the recipient. The procedure requires a qualified healthcare provider who is skilled in bone marrow harvesting and transplantation techniques.

5. When to use CPT code 38230

CPT code 38230 should be used when performing bone marrow harvesting for allogeneic transplantation. It is important to ensure that the procedure is specifically for allogeneic transplantation and not for other purposes, such as autologous transplantation.

6. Documentation requirements

To support a claim for CPT 38230, the healthcare provider must document the following information:

• Patient’s medical history and indication for bone marrow transplantation
• Details of the procedure, including the specific bone marrow site (sternum or iliac crest)
• Confirmation of appropriate anesthesia and sterilization
• Amount of bone marrow tissue harvested
• Container used for transplantation
• Control of bleeding at the insertion site
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 38230, ensure that the procedure is performed for allogeneic transplantation. It is important to follow the specific guidelines and requirements set by the payer. Additionally, consider any applicable modifiers or additional codes that may be necessary for accurate billing.

8. Historical information

CPT 38230 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A healthcare provider performing bone marrow harvesting from the sternum for allogeneic transplantation.
2. A qualified professional extracting bone marrow tissue from the iliac crest for allogeneic transplantation.
3. A donor undergoing bone marrow harvesting for allogeneic transplantation to a related recipient.
4. A healthcare provider performing bone marrow harvesting for allogeneic transplantation to an unrelated recipient.
5. A patient receiving bone marrow transplantation from a cadaver donor after the harvesting procedure.
6. A healthcare provider ensuring proper anesthesia and sterilization before performing bone marrow harvesting for allogeneic transplantation.
7. A qualified professional confirming the position of the needle in the bone marrow during the harvesting procedure.
8. A healthcare provider documenting the amount of bone marrow tissue harvested for transplantation.
9. A donor undergoing bone marrow harvesting for allogeneic transplantation, with appropriate control of bleeding at the insertion site.
10. A healthcare provider performing bone marrow harvesting for allogeneic transplantation, with a signature indicating their involvement in the procedure.