Summary & Overview
CPT 38241: Autologous Hematopoietic Progenitor Cell Reinfusion
CPT code 38241 denotes autologous hematopoietic progenitor cell (HPC) reinfusion, a procedure in which a patient’s own harvested progenitor cells are introduced into the bloodstream to restore bone marrow function. This procedure is clinically important for patients undergoing high-dose chemotherapy or other myeloablative therapies and has national relevance given its role in oncology and hematology care pathways.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise briefing on clinical context, typical sites of service, and the operational implications of billing for autologous HPC reinfusion. The publication summarizes common billing considerations, typical modifier usage where relevant, and how CPT code 38241 fits into the broader set of hematopoietic cell transplantation services.
The report provides national benchmarks and practical billing context, highlights policy and coverage considerations that affect access and reimbursement, and outlines the clinical scenarios in which CPT code 38241 is most commonly used. Data not available in the input will be noted where necessary.
Billing Code Overview
CPT code 38241 describes a procedure in which the provider introduces into a patient’s bloodstream hematopoietic progenitor cells (HPCs) that were harvested directly from the same patient. This procedure is a form of autologous hematopoietic cell transplantation where a patient’s own progenitor cells are reinfused to reestablish hematopoiesis following preparative therapy.
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Service type: Autologous hematopoietic progenitor cell reinfusion
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Typical site of service: Hospital inpatient or outpatient infusion center, depending on clinical status and institutional protocol
Clinical & Coding Specifications
Clinical Context
A typical patient is a 25–50-year-old adult undergoing autologous hematopoietic progenitor cell (HPC) infusion, where the provider reintroduces hematopoietic progenitor cells harvested previously from the same patient into the patient’s bloodstream. Common indications include hematologic malignancies (for example, relapsed lymphoma or multiple myeloma) following myeloablative or reduced-intensity conditioning, or recovery of bone marrow function after high-dose chemotherapy. The clinical workflow includes: pre-procedure evaluation (confirm cell product identity, infectious disease testing, crossmatch if indicated, and review of conditioning regimen timing), vascular access assessment (existing central venous catheter or placement), intravenous infusion of the HPC product under monitored conditions with vital sign and transfusion-reaction surveillance, post-infusion observation for immediate reactions, and coordination with the transplant team for inpatient monitoring of engraftment and supportive care. Typical site of service is an inpatient transplant unit or an ambulatory transplant infusion center depending on conditioning and institutional protocol. The service type is an autologous hematopoietic progenitor cell infusion derived from the patient’s own previously harvested cells.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Standard; no modifier required by payer | Rarely used as an explicit modifier; default billing when payer requires two-character code for no additional modifiers |