Summary & Overview
CPT 0585T: Laparoscopic Pancreatic Islet Cell Transplantation
CPT code 0585T denotes laparoscopic transplantation of pancreatic beta islet cells into the portal vein to restore insulin production in patients with diabetes. This emerging surgical-interventional procedure combines laparoscopic access with image-guided infusion and is billed as a single bundled service that includes imaging and radiological supervision. Nationally, the code represents advanced cellular therapy options aimed at reducing insulin dependence and managing complex diabetes cases.
Key payers discussed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and the procedural elements captured by the code. The publication outlines billing and coding considerations tied to the bundled imaging components and highlights benchmarking and coverage themes across major payers. It also summarizes policy and coverage pathways that are relevant to hospitals, transplant centers, and specialty clinics offering islet transplantation.
The report is intended for policy analysts, hospital billing teams, and clinical program managers seeking a national view of coding, site-of-service implications, and payer engagement for islet cell transplantation services.
Billing Code Overview
CPT code 0585T describes laparoscopic transplantation of pancreatic beta islet cells, using autologous or donor-derived islets to stimulate insulin production in patients with diabetes. The procedure involves infusion of the islet cells into the portal vein of the liver through a tube placed using laparoscopic techniques. All imaging, imaging guidance, and radiological supervision and interpretation are included with this procedure.
Service Type: Surgical, laparoscopic islet cell transplantation
Typical Site of Service: Inpatient or outpatient surgical facility with interventional radiology and operating room capabilities; tertiary care centers specializing in transplant and advanced diabetes therapies
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient with long-standing type 1 diabetes mellitus and recurrent severe hypoglycemia despite intensive medical management is evaluated for autologous or allogeneic pancreatic islet cell transplantation. The multidisciplinary workflow includes preoperative assessment (endocrinology, transplant surgery, interventional radiology), donor selection and islet isolation if allogeneic, perioperative imaging and labs, and a minimally invasive laparoscopic procedure to access the portal vein. During the procedure, the surgeon or interventionalist inserts a laparoscopic access catheter into the portal system and infuses isolated pancreatic beta islet cells into the portal vein to seed the liver and restore insulin production. Intraoperative ultrasound or fluoroscopic imaging guides catheter placement and monitors infusion. Postoperatively, the patient is observed in an inpatient setting for hemodynamic stability, portal vein patency, liver function monitoring, and glycemic control; immunosuppression is initiated if donor cells were used. Follow-up includes serial assessment of C-peptide, insulin requirements, and surveillance for procedure-related complications such as bleeding, portal vein thrombosis, or infection.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required exceeds typical service (e.g., extensive adhesiolysis during laparoscopic catheter placement). |
23 | Unusual anesthesia | Use when general anesthesia is contraindicated and substantial sedation or local/anxiolysis was provided under unusual circumstances. |
51 | Multiple procedures | Use when billed on the same day with additional distinct procedures performed during the same operative session. |
52 | Reduced services | Use when the procedure is started but not completed as planned, with significant reduction in service. |
53 | Discontinued procedure | Use when the procedure is terminated due to extenuating circumstances after anesthesia induction. |
62 | Two surgeons | Use when two surgeons with different specialties are required concurrently for surgical control or access. |
73 | Discontinued outpatient hospital/ambulatory surgery prior to anesthesia | Use when the procedure is cancelled after operating room preparation but before anesthesia in an outpatient setting. |
78 | Return to OR for related procedure during postoperative period | Use when a related unplanned operative procedure is required during the global period (e.g., re-exploration for bleeding). |
80 | Assistant surgeon required | Use when a qualified assistant surgeon is documented as assisting during the procedure. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services | Use when an allowed non-physician provider performs part of the service in accordance with payer rules. |
QK | Medical direction of two, three, or four concurrent anesthesia procedures | Use when the physician directs multiple concurrent anesthesia services supporting this procedure. |
QX | CRNA service furnished under physician supervision | Use when a certified registered nurse anesthetist provides anesthesia under supervising physician. |
QY | Medical direction of one CRNA by an anesthesiologist | Use when anesthesiologist medically directs a CRNA for this case. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 2080S0004X | Transplant Surgery | Primary surgical specialty performing islet transplant or laparoscopic portal access. |
| 208000000X | General Surgery | Surgeons trained in advanced laparoscopic procedures who may perform access and infusion. |
| 2086S0125X | Interventional Radiology | Image-guided portal vein access and infusion support; intraoperative imaging guidance. |
| 207L00000X | Endocrinology | Medical management pre- and post-transplant, patient selection, and metabolic follow-up. |
| 207K00000X | Internal Medicine | Perioperative medical management and inpatient care coordination. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
| Data not available in the input. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
0585T | Pancreatic beta islet cell transplantation; implantation of pancreatic islet cells into the portal vein via laparoscopic techniques (includes imaging and R/S/I) | Primary procedure for autologous or allogeneic islet infusion into the portal circulation to restore insulin production. |
76937 | Ultrasound guidance for vascular access requiring imaging and interpretation | May be used intraoperatively for portal vein localization and needle/catheter guidance when separate from included imaging. |
76937 | Ultrasound guidance for vascular access requiring imaging and interpretation | Duplicate entry is not intended; imaging for guidance is generally included with 0585T per description. |
96372 | Therapeutic, prophylactic, or diagnostic injection (specify substance) | May be reported for medications given perioperatively if not included in bundled service, depending on payer rules. |
36440 | Vascular access by venous cutdown, including catheter placement and removal, percutaneous | May be relevant if alternative vascular access techniques are required separate from laparoscopic portal access. |