Oncology & Hematology Coding Alert

Question: I have a patient who had a transfusion of T-cells from a donor. I have done some research and have found out that T-cells are one of the three main types of lymphocytes and are white blood cells that mature in the thymus, and they also are known as T-lymphocytes. Would code 86950 (leukocyte transfusion) be the correct code to use for this procedure?

Sharlene Evans
Fred Hutchinson Cancer Research Center, Seattle, WA

Answer: T-cells are lymphocytes that are developed in the bone marrow and then migrate to the thymus where they begin to mature. Immature T-cells are called thymocytes. Mature T-cells are antigen-specific, which means each one responds to only one antigen. There are T4 (helper) cells, T8 (suppressor) cells, and two types of cytotoxic cells (natural killer cells and cytotoxic T cells).

To report the transplantation of allogenic (non-patient donor) bone marrow or blood-derived peripheral stem cells, use code 38240 (bone marrow or blood-derived peripheral stem cell transplantation; allogenic). This code is used to report the implantation by injection via intravenous drip therapy or by IV push technique. Also code 90784 (therapeutic intravenous injection) for each IV push of additional drugs such as a prevention of graft rejection (graft-versus-host-disease). If your physician used a modification process to eliminate other cell type(s) from the bone marrow or stem cells, use code 86915 (bone marrow or peripheral stem cell harvest, modification or treatment to eliminate cell types).

If your physician collected the T-cells from the donor via cytapheresis, use code 38231 (blood-derived peripheral stem cell harvesting for transplantation, per collection).