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Hematopoietic progenitor cell (HPC) transplantation, commonly known as hematopoietic stem cell (HSC) transplantation, is a medical procedure that involves the infusion of progenitor cells into a recipient's bloodstream. These progenitor cells, which are essential for the formation of blood cells, can be sourced from various locations, including bone marrow, peripheral blood, or umbilical cord blood. The cells may be harvested from the patient themselves, referred to as autologous transplantation, or from a donor, known as allogeneic transplantation. In the case of allogeneic transplantation, the procedure is reported using CPT® Code 38240. Prior to the transplantation, the recipient undergoes a preparatory phase that includes myeloablative or immunosuppressive conditioning to create an optimal environment for the transplanted cells. Once the cells are harvested, they are typically frozen and stored until the transplantation is performed. During the actual procedure, the frozen hematopoietic progenitor cells are thawed, prepared, and then infused intravenously into the recipient. It is important to note that if multiple donors are involved in the transplantation process, CPT® Code 38240 should be reported for each allogeneic transplantation from a new donor. For cases involving autologous transplantation, CPT® Code 38241 is utilized instead.
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The indications for hematopoietic progenitor cell (HPC) allogeneic transplantation include a variety of hematological conditions and disorders that necessitate the replacement of damaged or dysfunctional blood cells. These conditions may include:
The procedure for hematopoietic progenitor cell (HPC) allogeneic transplantation involves several critical steps to ensure the successful infusion of donor cells into the recipient. These steps include:
After the hematopoietic progenitor cell (HPC) allogeneic transplantation, the recipient requires careful monitoring and supportive care to manage potential complications and ensure successful engraftment of the transplanted cells. Post-procedure care typically includes:
Close observation for signs of graft-versus-host disease (GVHD), a condition where the donor's immune cells attack the recipient's tissues, is essential. Patients may also experience neutropenia, thrombocytopenia, and anemia as their bone marrow recovers. Supportive care may involve transfusions of red blood cells and platelets, as well as antibiotics to prevent infections due to immunosuppression. The recovery period can vary, and regular follow-up appointments are necessary to monitor blood counts and overall health. Additionally, patients may require ongoing immunosuppressive therapy to prevent rejection of the transplanted cells and to manage any complications that arise during the recovery phase.
| Short Descr | TRANSPLT ALLO HCT/DONOR | Medium Descr | TRNSPLJ ALLOGENEIC HEMATOPOIETIC CELLS PER DONOR | Long Descr | Hematopoietic progenitor cell (HPC); allogeneic transplantation per donor | Status Code | Restricted Coverage | Global Days | XXX - Global Concept Does Not Apply | 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 | Hospital Part B services paid through a comprehensive APC | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 64 - Bone marrow transplant |
| Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | GZ | Item or service expected to be denied as not reasonable and necessary | 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. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CR | Catastrophe/disaster related | FS | Split (or shared) evaluation and management visit | GC | This service has been performed in part by a resident under the direction of a teaching physician | KX | Requirements specified in the medical policy have been met | 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 | Description Changed |
| 2012-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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