CPT 38215 Hematopoietic Progenitor Cell Prep Reimbursement | OpenPayer

Summary & Overview

CPT 38215: Hematopoietic Progenitor Cell Preparation

CPT code 38215 covers the preparation of hematopoietic progenitor cells (HPCs) by reducing plasma concentration and removing agranulocytes and the buffy coat layer to prepare a graft for hematopoietic stem cell transplantation. This code captures a specialized laboratory service that is central to the safety and efficacy of autologous and allogeneic hematopoietic transplants. Nationally, accurate coding for HPC processing supports appropriate billing, quality measurement and tracking of cellular therapy practices.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. Readers will find a concise overview of the clinical context for HPC processing, typical sites of service, and the operational role of this procedure in transplant workflows. The publication also surveys payer coverage patterns and benchmarking where available, highlights pertinent policy updates affecting cellular therapy billing, and summarizes common billing modifiers and documentation considerations. Data not provided in the input are noted as unavailable. This resource is intended to inform clinicians, coding professionals and administrators who manage billing and compliance for hematopoietic stem cell transplantation services.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare38215CPThematopoietic progenitor cellscell processingstem cell transplantationcellular therapylaboratory services

Billing Code Overview

CPT code 38215 describes preparation of hematopoietic progenitor cells (HPCs) by reducing plasma concentration and removing agranulocytes and the buffy coat layer to facilitate transplantation and reduce post‑transplant complications. This procedure is part of processing collected cellular material to yield a product suitable for hematopoietic stem cell transplantation.

Service type: Cell processing / hematopoietic progenitor cell preparation
Typical site of service: Hospital-based transfusion or cellular therapy laboratory; specialized cellular processing facility

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 45-year-old patient with relapsed non-Hodgkin lymphoma is scheduled for autologous hematopoietic progenitor cell (HPC) transplantation. The patient has completed mobilization with granulocyte colony-stimulating factor and underwent apheresis to collect peripheral blood stem cells. The laboratory service prepares the collected HPC product by reducing plasma volume and removing agranulocytes and the buffy coat layer to concentrate progenitor cells and reduce potential immunologic and infectious complications. The clinical workflow includes verification of donor/patient identifiers, product labeling, aseptic processing in a cellular therapy laboratory, cell counts and viability testing, infectious disease testing review, cryopreservation or immediate transfer to the transplant service, and documentation of the procedure and chain of custody. Typical sites of service are an inpatient bone marrow transplant unit, an outpatient hospital-based apheresis or cellular processing laboratory, or an ambulatory surgical center with a licensed cellular therapy facility.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When billing only the professional interpretation or reporting portion of a service provided by a physician related to the procedure, if applicable.
`52`

CPT 38212: HPC Product Preparation with Red Blood Cell Depletion

38220-BONE-MARROW-DIAGNOSTIC-ASPIRATIONS-ONLY-EG-BONE-MARROW

CPT 38220: Bone Marrow Diagnostic Aspiration Only

CPT-38227-CAR-T-CELL-EX-VIVO-MODIFICATION-CRYOPRESERVED-LYMPHOCYTES

CPT 38227: Ex Vivo Genetic Modification of Cryopreserved T Lymphocytes

CPT-38204-DONOR-SEARCH-HPC-ACQUISITION-MANAGEMENT

CPT 38204: Donor Search and Hematopoietic Progenitor Cell Acquisition

CPT-38207-HEMATOPOIETIC-PROGENITOR-CELL-PRESERVATION-STORAGE

CPT 38207: Management of Hematopoietic Progenitor Cell Preservation

CPT-38210-T-CELL-DEPLETED-HEMATOPOIETIC-PROGENITOR-CELL-PREPARATION

CPT 38210: T-Cell–Depleted Hematopoietic Progenitor Cell Preparation

CPT-38222-BONE-MARROW-ASPIRATION-BIOPSY-DIAGNOSTIC

CPT 38222: Bone Marrow Aspiration and Biopsy, Diagnostic

CPT-38225-CAR-T-T-LYMPHOCYTE-COLLECTION-APHERESIS

CPT 38225: T Lymphocyte Collection for CAR–T Therapy

CPT-38206-AUTOLOGOUS-HPC-APHERESIS-COLLECTION

CPT 38206: Autologous Hematopoietic Progenitor Cell Collection via Apheresis

CPT-38214-HPC-MINIMAL-PLASMA-VOLUME-PREPARATION

CPT 38214: Preparation of Hematopoietic Progenitor Cells with Minimal Plasma Volume

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Taxonomy Code	Specialty	Notes
207P00000X	Hematology	Physicians who manage transplantation and cellular therapy programs and direct procurement and infusion decisions.
2080P0208X	Transplant Surgery	Surgeons who perform bone marrow or stem cell procurement when surgical harvest is required.
363L00000X	Clinical Laboratory	Laboratory specialists who perform cellular processing, product manipulation, testing, and cryopreservation.
2084P0802X	Pediatric Hematology-Oncology	Specialists when the procedure is performed in pediatric patients.
363A00000X	Apheresis Nursing	Allied health clinicians and nurses specialized in apheresis and cellular product handling.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C83.9`	Non-Hodgkin lymphoma, unspecified	Malignancy commonly treated with autologous or allogeneic HPC transplantation; collected and processed progenitor cells support high-dose chemotherapy.
`C92.0`	Acute myeloblastic leukemia not having achieved remission	Acute leukemia indications where HPC transplantation may be part of definitive therapy and requires cell collection and processing.
`C91.00`	Acute lymphoblastic leukemia, not having achieved remission, not specified as to cell type	Leukemia subtype where HPC transplantation and product processing are clinically relevant.
`D47.Z1`	Chronic myeloproliferative disease, unspecified	Hematologic disorders that may require HPC transplantation; product manipulation reduces complications.
`Z94.84`	Bone marrow transplant status	Post-transplant care and potential need for subsequent product manipulation or re-transplantation workflows.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`38205`	Bone marrow harvesting for transplantation, percutaneous, needle or trocar; unilateral	Surgical harvest alternative when marrow, not peripheral blood stem cells, is collected prior to processing with `38215`-level manipulations.
`38206`	Bone marrow harvesting for transplantation, percutaneous, needle or trocar; bilateral	Same as `38205` when bilateral marrow harvest is required; harvested product may undergo processing similar to `38215` steps.
`38207`	Bone marrow harvesting for transplantation, open procedure	Open surgical harvest; product subsequently processed in the laboratory to remove plasma and buffy coat components.
`36415`	Collection of venous blood by venipuncture	Routine blood draws for pre-procedure testing, crossmatch, infectious disease testing, and cell counts related to transplantation workflow.
`36511`	Collection of blood from apheresis; multiple procedures (peripheral)	Apheresis collection code from which the collected HPC product is derived and then processed under `38215`.
`38240`	Hematopoietic progenitor cell (HPC), allogeneic; transplantation, including infusion and necessary product manipulation	Related transplant procedure code representing infusion and broader transplant services that may follow preparation steps like `38215`.

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