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Bone marrow harvesting for transplantation, specifically autologous harvesting, is a medical procedure that involves the extraction of bone marrow from a patient’s own body. Bone marrow is a vital substance found within the inner cavities of bones, primarily responsible for producing hematopoietic progenitor cells (HPCs), also known as hematopoietic stem cells (HSCs). These cells are crucial as they have the ability to develop into various types of mature blood cells, including red blood cells, which carry oxygen; platelets, which are essential for blood clotting; and white blood cells, which play a key role in the immune response. During the procedure, the patient is positioned lying prone on the operating table, and general anesthesia is administered to ensure comfort and pain relief. The area over the iliac crest, which is the top part of the hip bone, is thoroughly cleansed to maintain a sterile environment. A specialized needle is then inserted through the skin and into the bone to access the bone marrow. The extraction process begins with the collection of bone marrow from the first puncture site using a syringe attached to the needle. After this initial collection, the needle is withdrawn from the bone but remains in the skin, allowing for repositioning at a different angle or site within the same bone. This technique is repeated multiple times at various sites on the iliac crest to maximize the amount of bone marrow harvested. Once sufficient marrow has been collected from one side, the procedure may be performed on the opposite side of the iliac crest. The goal is to harvest approximately 2 quarts of bone marrow, which can then be used for transplantation purposes, particularly in treating conditions such as certain cancers or blood disorders. It is important to note that CPT® Code 38232 is specifically designated for autologous bone marrow harvesting, while a different code, 38230, is used when the bone marrow is harvested from a donor (allogeneic).
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The procedure of autologous bone marrow harvesting is indicated for various medical conditions that require the use of the patient's own stem cells for treatment. The following are the explicitly provided indications for this procedure:
The procedure for autologous bone marrow harvesting involves several critical steps to ensure the effective collection of bone marrow. The following procedural steps are outlined:
After the completion of the autologous bone marrow harvesting procedure, the patient is monitored for any immediate complications or adverse effects. Post-procedure care typically includes managing pain and discomfort, which may be addressed with analgesics as needed. The patient may experience soreness at the puncture sites, and care should be taken to keep these areas clean and dry to prevent infection. Recovery time can vary, but patients are generally advised to rest and avoid strenuous activities for a period following the procedure. Follow-up appointments may be scheduled to assess the patient's recovery and to discuss the next steps in the treatment plan, particularly regarding the transplantation process.
| Short Descr | BONE MARROW HARVEST AUTOLOG | Medium Descr | BONE MARROW HARVEST TRANSPLANTATION AUTOLOGOUS | Long Descr | Bone marrow harvesting for transplantation; autologous | 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 | Office-based surgical procedure added to ASC list in CY 2008 or later without MPFS nonfacility PE RVUs; 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 |
| 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. | RT | Right side (used to identify procedures performed on the right side of the body) | LT | Left side (used to identify procedures performed on the left side of the body) | 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. | 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). | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 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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| 2018-01-01 | Changed | AMA guidelines changed. |
| 2013-01-01 | Changed | AMA guidelines changed. |
| 2012-01-01 | Added | Added |
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