CPT® Code 38211

1. Indications

The procedure associated with CPT® Code 38211 is indicated for patients undergoing hematopoietic stem cell transplantation who require the removal of tumor cells from their harvested hematopoietic progenitor cells. This is particularly relevant for patients with a history of malignancies, where the presence of tumor cells in the harvested collection could lead to adverse outcomes if reinfused. The primary indications include:

• Presence of Malignancy Patients with a diagnosis of cancer who have undergone harvesting of hematopoietic progenitor cells and need to ensure that tumor cells are depleted prior to reinfusion.
• Stem Cell Transplantation Preparation Preparation of harvested cells for patients who are scheduled for autologous or allogeneic stem cell transplantation.

2. Procedure

The procedure for CPT® Code 38211 involves several critical steps to ensure the effective preparation of hematopoietic progenitor cells. Each step is designed to maximize the safety and efficacy of the cells for transplantation.

• Step 1: Thawing of Cells The first step involves thawing the cryopreserved hematopoietic progenitor cells. These cells, which have been stored at low temperatures with a cryoprotectant solution, are carefully thawed to restore their viability. This process must be conducted under controlled conditions to prevent damage to the cells.
• Step 2: Tumor Cell Depletion Following thawing, the next step is the specific separation of tumor cells from the progenitor cell collection. This is a critical process that ensures that any malignant cells present are effectively removed. Various techniques may be employed to achieve this, including immunomagnetic separation or density gradient centrifugation, depending on the specific protocols used.
• Step 3: Quality Control After tumor cell depletion, the prepared hematopoietic progenitor cells undergo quality control assessments to confirm that the tumor cells have been adequately removed and that the remaining cells meet the necessary criteria for transplantation. This may involve flow cytometry or other laboratory techniques to analyze the cell population.
• Step 4: Preparation for Infusion Once the quality control checks are completed, the hematopoietic progenitor cells are prepared for infusion. This includes resuspending the cells in an appropriate solution and ensuring that they are at the correct temperature for administration to the patient.

3. Post-Procedure

Post-procedure care following the preparation of hematopoietic progenitor cells is essential to ensure patient safety and the success of the transplantation. After the cells have been prepared and are ready for infusion, the healthcare team will monitor the patient closely for any potential reactions or complications. This may include managing any side effects from the cryoprotectant solution or monitoring for signs of infection. Additionally, the patient will be assessed for their overall health status and readiness for the actual transplantation procedure. Follow-up care will also involve regular evaluations to ensure that the transplanted cells are engrafting properly and that the patient is responding well to the treatment.