Summary & Overview
CPT 38206: Autologous Hematopoietic Progenitor Cell Collection via Apheresis
CPT code 38206 denotes the collection of hematopoietic progenitor cells (HPCs) from a patient’s peripheral blood using an apheresis procedure. This autologous HPC collection is a critical preparatory step for hematopoietic stem cell transplantation and cellular therapies. Nationally, the code is used across hospitals, outpatient apheresis units, and specialized infusion centers where trained teams and dedicated apheresis equipment perform the procedure.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical and billing context for CPT code 38206, an overview of common payer coverage patterns, and operational benchmarks relevant to the procedure. The publication summarizes typical sites of service, service components reflected by the code, and common modifiers used with this service where applicable.
This report provides clinicians, practice managers, and revenue cycle professionals with the clinical rationale for the code, payer considerations, and the types of documentation and care settings associated with autologous HPC apheresis. Data gaps in the input are noted where specific payer policy details or associated taxonomies and diagnoses were not provided.
Billing Code Overview
CPT code 38206 describes the harvest of hematopoietic progenitor cells (HPCs) from a patient's own blood using apheresis. The service involves collection of peripheral blood stem cells through apheresis equipment designed to separate and collect HPCs while returning other blood components to the patient.
Service Type: Autologous hematopoietic progenitor cell collection via apheresis
Typical Site of Service: Hospital inpatient or outpatient apheresis unit, specialized infusion center, or ambulatory surgical center where apheresis equipment and trained staff are available.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 45-year-old with multiple myeloma referred for autologous hematopoietic progenitor cell (HPC) collection prior to high-dose chemotherapy and stem cell rescue. The patient undergoes apheresis collection after mobilization with granulocyte-colony stimulating factor (G-CSF) with or without plerixafor. Pre-procedure evaluation includes history, vascular access assessment (peripheral veins or central venous catheter), lab testing (CBC, coagulation panel), and review of medications that affect anticoagulation. On the day of collection the apheresis nurse and apheresis physician/hematologist confirm informed consent, perform vital signs and point-of-care testing as indicated, and establish venous access. The provider operates the apheresis device to process peripheral blood, separating and collecting HPCs while returning remaining blood components to the patient. Typical collections range from one to several sessions until target CD34+ cell dose is achieved. Post-procedure monitoring includes hemostasis at access sites, observation for citrate toxicity (paresthesias, hypocalcemia), and documentation of volume collected and product labeling for storage or immediate transplant. Services are commonly performed in an outpatient apheresis unit, hospital inpatient unit, or ambulatory infusion center with specialized apheresis equipment and trained staff.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician professional component separate from facility technical component for interpretation/physician services related to the procedure |