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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 within the body, including bone marrow, peripheral blood, or umbilical cord blood. In the context of CPT® Code 38241, the transplantation is classified as autologous, meaning that the stem cells are harvested from the patient themselves, rather than from a donor (which would be termed allogeneic). Prior to the transplantation, the patient undergoes a preparatory phase that may include myeloablative or immunosuppressive conditioning to prepare the body for the incoming cells. The harvested progenitor cells are typically frozen and stored until the transplantation procedure is performed. During the actual procedure, these cells are thawed, prepared, and then infused intravenously into the patient, facilitating the restoration of healthy blood cell production. It is important to note that for allogeneic transplantation, a different code (CPT® Code 38240) is utilized, and if multiple donors are involved, each donor's contribution is reported separately using the same code. CPT® Code 38241 specifically pertains to the autologous transplantation of hematopoietic progenitor cells.
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The indications for hematopoietic progenitor cell (HPC) autologous transplantation, as described under CPT® Code 38241, include a variety of conditions that necessitate the restoration of healthy blood cell production. These may encompass:
The procedure for hematopoietic progenitor cell (HPC) autologous transplantation involves several critical steps, each essential for the successful outcome of the transplantation.
After the hematopoietic progenitor cell (HPC) autologous transplantation, patients are closely monitored for several factors. This includes observing for signs of engraftment, which is the successful establishment of the transplanted cells in the bone marrow. Patients may experience a period of neutropenia (low white blood cell count) and thrombocytopenia (low platelet count), necessitating supportive care, including transfusions and antibiotics to prevent infections. The recovery phase can vary in duration, and patients are often advised to follow up regularly with their healthcare team to manage any complications and to monitor their overall health. Long-term follow-up is essential to assess the effectiveness of the transplant and to address any late effects of the conditioning regimen or the transplantation itself.
| Short Descr | TRANSPLT AUTOL HCT/DONOR | Medium Descr | TRNSPLJ AUTOLOGOUS HEMATOPOIETIC CELLS PER DONOR | Long Descr | Hematopoietic progenitor cell (HPC); autologous transplantation | 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 | 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 | 64 - Bone marrow transplant |
| 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. | 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). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 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.) | AG | Primary physician | 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 | GZ | Item or service expected to be denied as not reasonable and necessary | KX | Requirements specified in the medical policy have been met | LT | Left side (used to identify procedures performed on the left side of the body) | 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 | RT | Right side (used to identify procedures performed on the right side of the body) | 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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| 2013-10-14 | Changed | Description Changed. Added "transplantation" effective 2013-10-14 per AMA Document dated 2014-03-24 |
| 2013-01-01 | Changed | Description Changed |
| 1990-01-01 | Added | First appearance in code book in 1990. |
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