Gain Rightful Reimbursement by Coding All the Steps in Stem Cell Treatment
Published on Sat Jul 01, 2000
Pathologists and laboratories specializing in hematology may work closely with oncologists in the treatment of various blood and lymphoid neoplasms such as acute leukemia (208.00 ) or non-Hodgkins lymphoma (202.80). Following high-dose chemotherapy, patients may be treated using stem cell transplantation. To ensure proper reimbursement, pathologists and labs involved with the various steps of stem cell collection, storage, and transplantation need to know the coding options so they can make the appropriate choices.
Stem cells are parent blood cells, which produce an ongoing supply of identical stem cells, as well as a supply of differentiated, mature blood cells of all types, including red blood cells, various types of white blood cells and platelets. They are found in a large concentration in the bone marrow and in a much lower concentration in the blood. A patient may receive his or her own stem cells (autologous transplant), or stem cells taken from a suitable, matching donor (allogenic transplant), either of which can be collected, or harvested, from blood or bone marrow and stored until needed for transplantation. Allogenic stem-cell transplantation provides the opportunity for treatment to patients who might be unsuitable for autologous transplant because of tumor involvement in the bone marrow or previous irradiation that compromised stem cell production. The goal of stem cell transplantation is to counter a loss of blood cells by transfusing parent cells into the patient to rebuild the blood supply, after high-dose chemotherapy destroys malignant cells.
Stem Cell Harvesting, Storage and Transplantation
We specialize in autologous peripheral stem cell transplantation because of the ease of collection, faster recovery and long-term disease benefits, reports Dipnarine Maharaj, MD, director of the Bone Marrow Stem Cell Transplant Institute at Bethesda, in Boynton Beach, Fla., and a fellow of the Royal College of Pathologists of the United Kingdom.
The patients oncologist and transplant physician (often a hematologist) will coordinate care carefully while the patient receives chemotherapy, states Maharaj. The patient typically has an intravenous catheter placed codes 36488-36533, depending on circumstances such as which vein is used and the patients age to facilitate the frequent blood analyses and treatment procedures that will be taking place, he continues.
Harvesting: Before stem cell collection, the patient will receive stem cell growth- stimulating factors, either through the catheter (if one is present); an IV push, 90784 (therapeutic, prophylactic or diagnostic injection [specify material injected]; intravenous); or subcutaneous injection, 90782 (therapeutic, prophylactic or diagnostic injection [specify material injected]; subcutaneous or intramuscular). Harvesting can take place as soon as the stem cell count in the peripheral blood is high enough, and white blood cell counts and marrow recovery are favorable, according to Maharaj.
Cytapheresis is the process of collecting blood, separating the stem [...]
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