How To Use CPT Code 38242

CPT 38242 describes the procedure of allogeneic lymphocyte infusions, which involves introducing lymphocytes into the bloodstream of a recipient. 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 38242?

CPT 38242 can be used to describe the procedure of allogeneic lymphocyte infusions. In this procedure, a healthcare provider harvests lymphocytes from a donor and introduces them into the bloodstream of a recipient. This service is typically performed for patients with recurrent infections or lymphoproliferative disease due to transplant.

2. Official Description

The official description of CPT code 38242 is: ‘Allogeneic lymphocyte infusions, which involves introducing lymphocytes into the bloodstream of a recipient, harvested from another donor.’

3. Procedure

1. In this procedure, the healthcare provider harvests lymphocytes from a donor’s blood.
2. The lymphocytes are separated from the donor’s blood.
3. The healthcare provider injects the lymphocytes directly into the recipient’s bloodstream through an intravenous drip in a sterile environment.
4. This infusion can be performed at any time after an initial transplant of hematopoietic progenitor cells (HPCs).

4. Qualifying circumstances

Allogeneic lymphocyte infusions are typically performed for patients with recurrent infections or lymphoproliferative disease due to transplant. The lymphocytes used in the procedure are harvested from another donor’s blood. The recipient may be related or unrelated to the donor. This procedure is also known as allograft or homograft.

5. When to use CPT code 38242

CPT code 38242 should be used when a healthcare provider performs allogeneic lymphocyte infusions, introducing lymphocytes into the bloodstream of a recipient. This procedure is typically done for patients with recurrent infections or lymphoproliferative disease due to transplant.

6. Documentation requirements

To support a claim for CPT 38242, the healthcare provider must document the following information:

• Reason for performing allogeneic lymphocyte infusions
• Details of the lymphocytes used, including their source and compatibility with the recipient
• Date and time of the procedure
• Method of introducing the lymphocytes into the recipient’s bloodstream
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 38242, ensure that the procedure involves introducing lymphocytes into the recipient’s bloodstream. Follow the appropriate coding guidelines and documentation requirements. It is important to note that CPT code 38242 should not be reported with other codes for bone marrow aspiration, bone graft, or platelet-rich stem cell injection.

8. Historical information

CPT 38242 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 patient with recurrent infections receives allogeneic lymphocyte infusions to boost their immune system.
2. A recipient of a bone marrow transplant undergoes allogeneic lymphocyte infusions to treat lymphoproliferative disease.
3. A healthcare provider performs allogeneic lymphocyte infusions on a patient with graft-versus-host disease.
4. An individual with a compromised immune system receives allogeneic lymphocyte infusions to improve their ability to fight infections.
5. A patient with lymphoma undergoes allogeneic lymphocyte infusions as part of their treatment plan.
6. A recipient of a stem cell transplant receives allogeneic lymphocyte infusions to prevent or treat relapse.
7. An individual with a history of transplant-related complications undergoes allogeneic lymphocyte infusions to improve their overall health.
8. A patient with a rare immunodeficiency disorder receives allogeneic lymphocyte infusions to enhance their immune response.
9. An individual with a history of recurrent viral infections undergoes allogeneic lymphocyte infusions to boost their immune system.
10. A healthcare provider performs allogeneic lymphocyte infusions on a patient with a compromised immune system due to chemotherapy.