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    v1.0.30
    OpenPayerBilling CodesCellular Regeneration, Evaluation Study and Ablation ProceduresCPT cpt-0490t-autologous-adipose-regenerative-cells-for-hand-scleroderma
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    CPT 0490T: Autologous Adipose-Derived Regenerative Cell Injection for Scleroderma

    CPT code 0490T describes harvesting a patient’s own adipose (fat) tissue, processing it to concentrate and dilute regenerative cells, and injecting the resulting autologous cell preparation into one or both hands for treatment of scleroderma; service type: autologous adipose-derived regenerative cell therapy; typical site of service: ambulatory surgical center or procedure suite / outpatient clinic where fat harvest and injections are performed.

    For related coverage guidance, see recent payer policy updates: Mohs Micrographic Surgery, Mohs Micrographic Surgery, Mohs Micrographic Surgery.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult with systemic sclerosis (scleroderma) experiencing progressive digital fibrosis, pain, stiffness, reduced range of motion, and impaired hand function. The treating provider (often a plastic surgeon, hand surgeon, or rheumatologist working with procedural specialists) performs ambulatory lipoharvest of the patient’s subcutaneous adipose tissue under local or monitored anesthesia care. The harvested adipose tissue is processed in a closed or laboratory system to concentrate regenerative cells and remove excess fluid, then multiple injections of the processed autologous cell/fat suspension are delivered into both hands (subcutaneous and periarticular tissues of the digits) to address skin tightness and microvascular and soft-tissue changes. Typical workflow: preprocedure evaluation and informed consent, sterile lipoharvest (abdomen or thigh), processing/centrifugation or filtration, multiple hand injections (often bilateral, multiple digits), brief postprocedure observation in an outpatient surgical center or office procedure room, and discharge with wound and activity instructions. Typical site of service: outpatient ambulatory surgery center or office-based procedure room with appropriate sterile and monitoring capabilities. Typical payors involved include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare for coverage adjudication and medical necessity review.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    20926Tissue grafts, other (e.g., fat), for soft tissue augmentation (includes obtaining graft)Alternative/additional code sometimes reported for autologous fat grafting of small volumes; may be considered when reporting graft placement procedures in conjunction with processing.
    15771Application of skin substitutes, open wound, first 25 sq cm or lessMay be performed for hand skin defects in scleroderma patients in separate encounters; not typically reported with 0490T on same day.
    36415Collection of venous blood by venipunctureMay be reported for preprocedure laboratory testing or blood draws related to the procedure.
    01996Delivery of regenerative medicine services (unlisted regenerative medicine procedure)Used in some cases when specific regenerative processing or delivery methods are not captured by existing codes; relate carefully to 0490T reporting rules.
    99143Moderate sedation services provided by a physician; initial 30 minutes intra-service timeReported when moderate sedation is provided by the physician during lipoharvest or injection in the office setting (follow payer guidelines).

    Related Modifiers

    11 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…

    Showing 1–10 of 11

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208000000X
    208800000X
    207Q00000X
    363A00000X
    367500000X
    103TE1100X
    2471C1101X
    163WP0808X

    Related ICD-10-CM Codes

    23 rows

    ICD-10-CM CodeDescription
    G60.9Hereditary and idiopathic neuropathy, unspecified
    I73.9Peripheral vascular disease, unspecified
    L03.115Cellulitis of right lower limb
    L03.116Cellulitis of left lower limb
    L94.0Localized scleroderma [morphea]
    L98.9Disorder of the skin and subcutaneous tissue, unspecified
    M25.50Pain in unspecified joint
    M25.521Pain in right elbow
    M34.0Progressive systemic sclerosis
    M34.1CR(E)ST syndrome

    Showing 1–10 of 23

    Related Payer Policy Updates

    Specialty: Dermatology1 / 3

    10 rows

    PolicyPayerEffective Date
    Mohs Micrographic Surgerypremerabluecrossofwashington2027-02-05
    Mohs Micrographic Surgerypremerabluecrossofwashington2027-02-05
    Mohs Micrographic Surgerypremerabluecrossofwashington2027-02-05
    FilsuvezCigna2026-11-01
    Destruction of Pre-Malignant Skin LesionsAnthem2026-10-01
    Onychomycosis diagnostic testing and coverageOscar Health2026-10-01
    Treatment of Capillary Malformations (Port Wine Stains)universityofutahhealthplans2026-09-28
    AnzupgoCigna2026-09-15
    Hyperhidrosispriority_health_medicare2026-09-01
    Zevaskyn Coverage for Recessive Dystrophic Epidermolysis BullosaCigna2026-09-01

    Related Codes

    CPT-0489T-AUTOLOGOUS-ADIPOSE-REGENERATIVE-CELL-THERAPY-SCLERODERMA-HANDS

    CPT 0489T: Autologous Adipose-Derived Cell Therapy for Scleroderma of the Hands

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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