Current available treatments include growth factor support (e.g., granulocyte colony stimulating factors including Neupogen and filgrastim granulocyte macrophage-colony stimulating factors including Leukine and sargramostim), lenalidomide, hypo-methylating agents (e.g., azacitidine and decitabine), intensive chemotherapy, and hematopoietic stem-cell transplantation (HSCT). In the latter group, the objective is to prolong survival. In the former group, the goal is to decrease transfusion needs and transformation to higher risk disease or AML.
Goals of therapy are different in lower risk patients than in higher risk patients. Treatment of patients with MDS is selected basing on risk, transfusion needs, percent of bone marrow blasts, and, more recently, cytogenetic profile. The most commonly used system is the International Prognostic Scoring System (IPSS), which is likely to be replaced by a new revised score (IPSS-R) and by the incorporation of new molecular markers recently described. In general, these scoring systems include analysis of peripheral cytopenias, percentage of blasts in the bone marrow and cytogenetic characteristics. Prognosis of patients with MDS can be calculated using a number of scoring systems. Diagnosis of MDS is based on morphological evidence of dysplasia upon visual examination of a bone marrow aspirate and biopsy. Secondary MDS usually has a poorer prognosis and mainly affects adults aged 60 or older with a 2-year overall survival (OS) of less than 20 % with advanced MDS. secondary (as a consequence of cytotoxic therapy, ionizing radiation, or other environmental insults).Myelodysplastic syndromes (MDS) refer to a heterogeneous group of myeloid disorders characterized by impaired maturation of hematopoietic cells, peripheral blood cytopenias and increased risk of transformation into acute myelogenous leukemia (AML). ICD-10 codes covered if selection criteria are met: HCPCS codes covered if selection criteria are met:īone marrow or blood-derived stem cells (peripheral or umbilical), allogeneic or autologous, harvesting, transplantation, and related complications including: pheresis and cell preparation/storage marrow ablative therapy drugs, supplies, hospitalization with outpatient follow-up medical/surgical, diagnostic, emergency, and rehabilitative services and the number of days of pre- and post-transplant care in the global definition Histocompatibility/blood typing/identity/microsatellite Hematopoietic progenitor cell (HPC) autologous transplantationīone marrow or stem cell services/procedures
Hematopoietic progenitor cell (HPC) allogeneic transplantation per donorĬPT codes not covered for indications listed in the CPB:īlood-derived hematopoietic progenitor cell harvesting for transplantation, per collection autologousīone marrow harvesting for transplantation autologous Codes requiring a 7th character are represented by "+":ĬPT codes covered if selection criteria are met :īlood-derived hematopoietic progenitor cell harvesting for transplantation, per collection allogeneicīone marrow harvesting for transplantation allogeneic Information in the below has been added for clarification purposes.
#AUTOLOGOUS STEM CELL TRANSPLANT ICD 10 CODE#
Table: CPT Codes / HCPCS Codes / ICD-10 Codes Code CPB 0634 - Non-myeloablative Hematopoietic Cell Transplantation (Mini-Allograft / Reduced Intensity Conditioning Transplant.Number: 0836 Table Of Contents Policy Applicable CPT / HCPCS / ICD-10 Codes Background ReferencesĪetna considers allogeneic (ablative and non-myeloablative) hematopoietic cell transplantation medically necessary for individuals with intermediate-risk or high-risk myelodysplastic syndrome (MDS), and who have not responded to prior therapy and have an available human leukocyte antigen (HLA)-compatable donor.Īetna considers a repeat allogeneic (ablative or non-myeloablative) hematopoietic cell transplantation medically necessary for individuals with intermediate-risk or high-risk MDS due to primary graft failure, failure to engraft, or late relapse (greater than 18 months after HCT) (salvage therapy).Īetna considers a repeat allogeneic (ablative or non-myeloablative) hematopoietic cell transplantation experimental and investigational for individuals with MDS who early relapse.Īetna considers autologous hematopoietic cell transplantation experimental and investigational for individuals with MDS because the effectiveness of this approach for this indication has not been established.
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