CPT® Code 38209

1. Indications

The procedure described by CPT® Code 38209 is indicated for the preparation of hematopoietic progenitor cells for transplantation. The specific indications include:

• Malignant Neoplasms The procedure is performed in the context of treating malignant conditions such as leukemia and lymphoma, where HPCs are utilized to restore healthy blood cell production.
• Sickle Cell Disease HPCs are also indicated for patients with sickle cell disease, providing a potential curative treatment option through stem cell transplantation.

2. Procedure

The procedure for CPT® Code 38209 involves several critical steps to ensure the safe and effective preparation of hematopoietic progenitor cells for transplantation. These steps include:

• Thawing of Cells The first step involves thawing the previously frozen hematopoietic progenitor cells. This is typically done in a controlled environment, such as a heated water bath, to ensure that the cells are thawed uniformly and safely, minimizing damage to the cells.
• Washing of Cells After thawing, the cells undergo a washing process. This step is crucial when multiple aliquots of harvested cells have been frozen over several days. The washing is performed using an automated cell washer, which helps to remove excess dimethyl sulfoxide (DMSO) that was used during the cryopreservation process. The removal of DMSO is essential to prevent toxicity, as higher concentrations can be harmful to the cells.
• Concentration and Resuspension During the washing process, the cells are concentrated and resuspended in an appropriate infusible solution, such as saline or albumin. This step ensures that the cells are in a suitable form for infusion into the patient.
• Quality Assessment Following the washing and resuspension, a quality assessment is performed on the washed cells. This assessment is critical to ensure that the cells are still viable and suitable for transplantation. The quality check may include evaluating the nucleated cell count, differential, viability, sterility, and/or immunophenotyping.
• Physician Review Once the quality assessment is completed, the results are reviewed by a physician. The physician determines whether the prepared hematopoietic progenitor cells can be used in the transplant procedure based on the quality assessment findings.

3. Post-Procedure

After the procedure associated with CPT® Code 38209, the prepared hematopoietic progenitor cells are ready for infusion into the patient as part of the stem cell transplant process. It is essential to monitor the patient closely for any potential reactions or complications following the infusion. Additionally, the healthcare team may provide specific post-procedure care instructions to ensure the patient's recovery and support the engraftment of the transplanted cells. Continuous follow-up and assessment of the patient's response to the transplant are also critical components of post-procedure care.