© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 0748T involves the injection of a stem cell product into the perianal perifistular soft tissue, specifically targeting the treatment of perianal fistulas. These fistulas often arise as a complication of Crohn’s disease, a chronic inflammatory bowel condition. The use of mesenchymal stem cells, which can be sourced from either bone marrow or adipose tissue, is integral to this treatment. One such product, Darvadstrocel (Alofisel), is utilized for its therapeutic properties, which include the ability to mitigate inflammatory responses, enhance T cell formation, and differentiate into fibroblasts. This differentiation is crucial as it aids in the formation of a healing scar within the fistula, promoting closure and recovery. Prior to the injection, the physician prepares the fistula site, which may involve the removal of setons, curettage of the fistula tract, or closure of any internal openings that connect the fistula to surrounding tissues. This preparation is essential to ensure the effectiveness of the stem cell injection and to optimize the healing process.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure is indicated for the treatment of perianal fistulas, particularly those that may develop as a complication of Crohn’s disease. This condition can lead to significant discomfort and complications, necessitating effective intervention to promote healing and reduce inflammation.
The procedure begins with the administration of general anesthesia to ensure patient comfort during the intervention. Following anesthesia, the physician prepares the fistula for the injection of the stem cell product. This preparation may involve several steps, including the removal of any existing setons, which are threads placed through the fistula to maintain its patency. The physician may also perform curettage within the fistula tract to clean the area and remove any necrotic tissue. Additionally, if there are internal openings connecting the fistula to surrounding tissues, these may be surgically closed to enhance the effectiveness of the treatment. Once the preparation is complete, the total amount of stem cell product is divided in half. The physician then inserts a needle through the anal opening and injects half of the stem cell medication into the perianal perifistular soft tissue surrounding each internal opening, creating small blebs to ensure adequate distribution. The remaining half of the stem cell product is injected into the external opening of the fistula and along the length of the tract. After the injections, the physician massages the area around the external openings for a few seconds to facilitate the distribution of the stem cells before applying a sterile bandage to protect the site.
Post-procedure care involves monitoring the injection site for any signs of infection or complications. Patients may be advised on wound care and hygiene practices to maintain the integrity of the treated area. Follow-up appointments may be scheduled to assess healing and the effectiveness of the treatment. It is important for patients to report any unusual symptoms, such as increased pain or discharge, to their healthcare provider promptly.
| Short Descr | NJX STM CL PRDCT ANL SFT TIS |
| Medium Descr | NJX STEM CLL PRDCT PERIANAL PERIFISTULAR SFT TIS |
| Long Descr | Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings) |
| Status Code | Carriers Price the Code |
| Global Days | YYY - Carrier Determines Whether Global Concept Applies |
| PC/TC Indicator (26, TC) | 0 - Physician Service Code |
| Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. |
| Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. |
| Physician Supervisions | 09 - Concept does not apply. |
| Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... |
| Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. |
| Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. |
| Diagnostic Imaging Family | 99 - Concept Does Not Apply |
| APC Status Indicator | Non-Covered Service, not paid under OPPS |
| Berenson-Eggers TOS (BETOS) | none |
| MUE | Not applicable/unspecified. |
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Notes
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| 2023-01-01 | Added | Code added. |