CPT® Code 0490T

1. Indications

The autologous adipose-derived regenerative cell therapy is indicated for the treatment of scleroderma specifically affecting the hands. This condition is characterized by various symptoms and complications that can significantly impair hand function and quality of life. The following indications are associated with this procedure:

• Scleroderma of the hands - A chronic connective tissue disorder leading to skin hardening and dysfunction in the hands.
• Ischemia - Reduced blood flow to the hands, which can cause pain and tissue damage.
• Fibrosis - Thickening and scarring of the skin and connective tissues in the hands.
• Painful digital ulcers - Open sores on the fingers that can be painful and slow to heal.
• Sclerodactyly - Tightening of the skin on the fingers, leading to limited mobility.
• Raynaud’s phenomenon - Episodes of reduced blood flow to the fingers, often triggered by cold or stress.
• Pale discoloration of the skin - Changes in skin color due to narrowed blood vessels.
• Calcium deposits in soft tissue - Accumulation of calcium that can lead to further complications.
• Swelling and puffiness - Increased fluid retention in the hands, contributing to discomfort.
• Joint pain and stiffness - Discomfort and reduced range of motion in the joints of the hands.

2. Procedure

The procedure for autologous adipose-derived regenerative cell therapy involves several critical steps to ensure the effective treatment of scleroderma in the hands. Each step is designed to maximize the therapeutic potential of the harvested cells.

• Step 1: Harvesting of adipose tissue - The first step involves the collection of adipose tissue from the patient using a small volume liposuction technique. This minimally invasive procedure allows for the extraction of fat cells, which are rich in regenerative properties.
• Step 2: Isolation and preparation of ADRCs - Once the adipose tissue is harvested, it undergoes a preparation process that includes incubation with cell dissociation enzymes. This step is crucial for breaking down the tissue and isolating the regenerative cells.
• Step 3: Removal of non-viable cells and debris - After the incubation, the preparation process continues with the removal of non-viable cells and any debris that may be present. This ensures that only healthy, viable cells are used for therapy.
• Step 4: Determination of concentration and dilution - Following the isolation of the ADRCs, the concentration and dilution of the cells are assessed. This step is essential to prepare the cells for injection, ensuring that the correct dosage is administered.
• Step 5: Injection into the hands - Finally, the prepared ADRCs are injected into the patient’s hand(s) on the same day as the harvesting. Multiple injections may be performed in one or both hands, targeting the areas affected by scleroderma to provide therapeutic benefits.

3. Post-Procedure

After the autologous adipose-derived regenerative cell therapy procedure, patients may experience a range of outcomes and considerations for post-procedure care. It is important to monitor the injection sites for any signs of adverse reactions, such as swelling, redness, or pain. Patients are typically advised to avoid strenuous activities with their hands for a period following the injections to allow for optimal healing and integration of the regenerative cells. Follow-up appointments may be scheduled to assess the effectiveness of the treatment and to monitor the progression of scleroderma symptoms. Additionally, patients should be informed about potential side effects and the importance of reporting any unusual symptoms to their healthcare provider. Overall, the goal of post-procedure care is to support recovery and enhance the therapeutic effects of the ADRC therapy.