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Bone marrow harvesting for transplantation, as described by CPT® Code 38230, involves the extraction of bone marrow from a donor for the purpose of transplantation. Bone marrow is a vital tissue found within the cavities of bones, primarily responsible for the production of blood cells. It contains hematopoietic progenitor cells (HPCs), also known as hematopoietic stem cells (HSCs), which are essential for generating mature blood components, including red blood cells, platelets, and white blood cells. The procedure is typically performed under general anesthesia, with the patient positioned prone on the operating table to facilitate access to the iliac crest, a common site for bone marrow collection. The harvesting process involves the insertion of a needle through the skin and into the bone to extract marrow, which may be repeated at multiple sites to ensure an adequate volume is collected. This procedure is specifically indicated for allogeneic transplants, where the donor and recipient are different individuals, and is distinct from autologous harvesting, where the patient’s own marrow is collected, which is coded separately under CPT® Code 38232.
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The procedure of bone marrow harvesting for transplantation is indicated for various conditions that require hematopoietic stem cell transplantation. These indications include:
The bone marrow harvesting procedure involves several critical steps to ensure the safe and effective collection of bone marrow from the donor. The steps are as follows:
After the bone marrow harvesting procedure, the donor is monitored for any immediate complications or adverse reactions to the anesthesia. Post-procedure care typically includes pain management, as some discomfort at the puncture sites is expected. The donor may be advised to rest and avoid strenuous activities for a specified period to facilitate recovery. Follow-up appointments may be scheduled to assess the donor's recovery and to monitor for any potential complications, such as infection or excessive bleeding at the harvest sites. It is essential for the donor to adhere to any specific post-operative instructions provided by the healthcare team to ensure a smooth recovery process.
| Short Descr | BONE MARROW HARVEST ALLOGEN | Medium Descr | BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC | Long Descr | Bone marrow harvesting for transplantation; allogeneic | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Not Discounted when Multiple | ASC Payment Indicator | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 67 - Other therapeutic procedures, hemic and lymphatic system |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2013-01-01 | Changed | Guideline information changed. |
| 2012-01-01 | Changed | Description Changed |
| Pre-1990 | Added | Code added. |
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