How To Use CPT Code 38240

CPT 38240 describes the transplantation of hematopoietic progenitor cells (HPC) from a donor to a recipient. 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 38240?

CPT 38240 can be used to describe the transplantation of hematopoietic progenitor cells (HPC) from a donor to a recipient. This procedure involves the introduction of HPCs, which are parent cells found in the bone marrow, into the recipient’s bloodstream. The goal of this transplantation is to provide complete suppression of the recipient’s immune system so that the foreign cells are not rejected.

2. Official Description

The official description of CPT code 38240 is: ‘Hematopoietic progenitor cell (HPC); allogeneic transplantation per donor.’

3. Procedure

1. The provider collects hematopoietic progenitor cells from the donor’s bone marrow.
2. The provider injects the collected cells into the recipient’s bloodstream through an intravenous drip, under sterile conditions.

4. Qualifying circumstances

CPT 38240 is used for allogeneic transplantation, which means the tissue graft is harvested from one person for another. The donor can be a cadaver or a living individual related or unrelated to the recipient. The procedure involves the transplantation of hematopoietic progenitor cells (HPCs) from the donor to the recipient.

5. When to use CPT code 38240

CPT code 38240 should be used when performing allogeneic transplantation of hematopoietic progenitor cells (HPCs) from a donor to a recipient. It is important to note that this code is specifically for transplantation procedures and should not be used for other types of cellular infusion procedures.

6. Documentation requirements

To support a claim for CPT 38240, the provider must document the following information:

• Details of the transplantation procedure, including the source of the hematopoietic progenitor cells (HPCs) and the method of introduction into the recipient’s bloodstream
• Date of the procedure
• Signature of the provider performing the transplantation

7. Billing guidelines

When billing for CPT 38240, ensure that the procedure meets the criteria for allogeneic transplantation of hematopoietic progenitor cells (HPCs). It is important to follow the specific documentation requirements and provide accurate information for proper reimbursement.

8. Historical information

CPT 38240 was added to the Current Procedural Terminology system on January 1, 1990. There have been some changes to the code over the years, including updates to the description and code range.

9. Examples

1. A provider performs an allogeneic transplantation of hematopoietic progenitor cells (HPCs) from a living unrelated donor to a recipient.
2. A patient receives an allogeneic transplantation of hematopoietic progenitor cells (HPCs) from a cadaver donor to treat a blood disorder.
3. A provider performs an allogeneic transplantation of hematopoietic progenitor cells (HPCs) from a related living donor to a recipient with leukemia.
4. A patient undergoes an allogeneic transplantation of hematopoietic progenitor cells (HPCs) from a sibling donor to treat a genetic blood disorder.
5. A provider performs an allogeneic transplantation of hematopoietic progenitor cells (HPCs) from a matched unrelated donor to a recipient with lymphoma.
6. A patient receives an allogeneic transplantation of hematopoietic progenitor cells (HPCs) from a related living donor to treat aplastic anemia.
7. A provider performs an allogeneic transplantation of hematopoietic progenitor cells (HPCs) from a cadaver donor to a recipient with myelodysplastic syndrome.
8. A patient undergoes an allogeneic transplantation of hematopoietic progenitor cells (HPCs) from a matched unrelated donor to treat multiple myeloma.
9. A provider performs an allogeneic transplantation of hematopoietic progenitor cells (HPCs) from a related living donor to a recipient with sickle cell disease.
10. A patient receives an allogeneic transplantation of hematopoietic progenitor cells (HPCs) from a cadaver donor to treat a bone marrow failure disorder.