Summary & Overview
CPT 38211: Hematopoietic Progenitor Cell Tumor-Reduction Processing
CPT code 38211 represents specialized processing of hematopoietic progenitor cells (HPCs) using enrichment and depletion techniques to remove tumor cells prior to transplantation. This code is nationally relevant due to growing use of autologous and allogeneic cellular therapies, where minimizing tumor reinfusion is clinically important for patient safety and graft integrity. The procedure is typically performed in hospital or specialized cellular therapy laboratories and is associated with advanced laboratory workflows and quality controls.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and coding intent, payor coverage considerations, and operational benchmarks where available. The publication also summarizes typical sites of service and the service type to aid billing and revenue cycle teams.
This report provides national-level guidance on coding semantics and clinical purpose, highlights common payer coverage patterns, and points to policy and billing topics readers should review when managing claims for complex cellular therapy processing. Data not available in the input are clearly identified where applicable.
Billing Code Overview
CPT code 38211 describes preparation of hematopoietic progenitor cells (HPCs) using a combination of enrichment and depletion techniques intended to remove as many tumor cells as possible to minimize the chance of reintroducing tumor cells into the recipient. The procedure focuses on cellular processing to reduce tumor contamination in collected HPC products prior to transplantation or infusion.
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Service type: Cell processing and tumor cell reduction procedures for hematopoietic progenitor cell products
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Typical site of service: Hospital laboratory, hospital outpatient facility, or specialized cellular therapy processing laboratory
Clinical & Coding Specifications
Clinical Context
A typical patient is a 45–65-year-old adult with a hematologic malignancy such as non-Hodgkin lymphoma or acute myeloid leukemia who is scheduled for autologous or allogeneic hematopoietic progenitor cell (HPC) transplantation. The workflow begins with oncology evaluation and staging, mobilization of peripheral blood stem cells with growth factors (with or without plerixafor), and apheresis collection of HPCs. The collected product is transported to the cell processing laboratory where the provider performs combined enrichment and depletion techniques to remove tumor cells from the graft (tumor cell purging) per protocol. Processed HPCs are tested for cell counts, viability, infectious disease markers, and sterility. The final product is released for cryopreservation or immediate infusion. Documentation includes indication for purging, method(s) used, percent tumor cell reduction when available, product volume and cell counts, personnel and facility identifiers, and date/time of processing. Typical site of service is an academic medical center or hospital-based cell processing laboratory supporting transplant programs.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the professional component of a consulting physician associated with the procedure. |
62 |