Summary & Overview
HCPCS S2142: Cord Blood-Derived Allogeneic Stem-Cell Transplantation
HCPCS Level II code S2142 represents cord blood-derived, allogeneic hematopoietic stem-cell transplantation. This high-complexity procedure is central to treatment strategies for select hematologic malignancies, marrow failure states, and inherited disorders that require donor stem-cell engraftment. Nationally, access to and coverage of cord blood transplantation affect clinical pathways for patients lacking matched related donors and influence hospital and transplant center resource planning.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines payer coverage patterns, payment benchmarks where available, and the clinical context that informs utilization of cord blood grafts versus other donor sources. Readers will find a concise overview of the code’s scope, typical sites of service, and the clinical scenarios that prompt use of cord blood allografts, followed by summaries of payer coverage approaches and any notable policy considerations.
This briefing is intended to provide clinicians, billing professionals, and policy analysts with a national-level reference on HCPCS Level II code S2142, offering clarity on what the code denotes, which payers are addressed, and the topics covered in the full publication.
Billing Code Overview
HCPCS Level II code S2142 describes cord blood-derived stem-cell transplantation, allogeneic. This service involves the transplantation of hematopoietic stem cells derived from donated umbilical cord blood, intended to reconstitute bone marrow and immune function in recipients with hematologic malignancies, marrow failure syndromes, or select genetic disorders.
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Service type: Allogeneic stem-cell transplantation using cord blood-derived grafts
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Typical site of service: Hospital inpatient or specialized transplant center with capabilities for hematopoietic stem-cell transplantation
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Clinical & Coding Specifications
Clinical Context
A 6-year-old child with high‑risk B‑cell acute lymphoblastic leukemia in second complete remission is admitted for an allogeneic umbilical cord blood stem‑cell transplantation S2142. The patient has an HLA‑matched unrelated cord blood unit identified, has completed pre‑transplant conditioning (myeloablative regimen), and receives inpatient multidisciplinary care including transplant physician oversight, nursing, pharmacy for immunosuppressive medications, infectious disease consultations, and blood bank support. The clinical workflow begins with pre‑transplant evaluation and eligibility confirmation, procurement and thawing of the cord blood unit on the transplant day, infusion of the cryopreserved cord blood cells in a sterile procedural area or inpatient infusion unit, immediate post‑infusion monitoring for infusion‑related reactions, and continued inpatient monitoring for engraftment, graft‑versus‑host disease prophylaxis and management, infection surveillance, and supportive care until adequate neutrophil and platelet recovery and clinical stability for discharge. Documentation includes the donor source as cord blood, allogeneic status, total nucleated cell dose or CD34+ cell count if available, conditioning regimen, dates of infusion, and detailed progress notes regarding infusion tolerance and subsequent engraftment milestones.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral procedure |