This edition of “Spotlight on CPT” presents information regarding the coding for CAR-T cell therapy.
In January of 2025 a new section was added under the Hemic and Lymphatic Systems entitled General. Under this new section is a subsection for Cellular and Gene Therapies. The four new codes listed in that subsection address coding for CAR-T cell therapy.
What is CAR-T cell therapy? It is an immunotherapy treatment for cancer, primarily those that affect the blood such as multiple myeloma and leukemia. CAR-T stands for chimeric antigen receptor. In a lab, this protein is added to a patient’s T cells enabling the body’s own immune system to target and fight the cancer cells. When the modified cells are reintroduced into the body, the CAR-T cells will bind to antigens on the cancer cells. This activates the T-cells to destroy the cancer cells.
The illustration below shows the process that a patient having CAR-T cell therapy will undergo. First, T-cells are harvested from the patient. At the lab, the cells are genetically modified and then replicated. The cells are then infused back into the patient where they perform the functions of binding to the cancer cells and then destroying them.
Source: https://www.civilsdaily.com/news/car-t-cancer-therapy/
The new codes in CPT for CAR-T cell encompass different aspects of the process.
38226 preparation of blood-derived T lymphocytes for transportation (eg, cryopreservation, storage)
38227 receipt and preparation of CAR-T cells for administration
38228 CAR-T cell administration, autologous
Note the collection code can only be assigned once per day, with the same being true for the administration code no matter how many units are administered.
There are several notes that precede the CAR-T codes. Coding professionals should review them before assigning any codes. This is especially true when the cells are being infused back into the patient. Note the following instructions:
Do NOT report the following with CAR-T cell administration:
DO report
It will be necessary to use modifier 59 for hydration or other medication administration that would be unrelated to CAR-T cell administration in order to receive payment for those services.
Now, light has been shed on coding for CAR-T.
In January of 2025 a new section was added under the Hemic and Lymphatic Systems entitled General. Under this new section is a subsection for Cellular and Gene Therapies. The four new codes listed in that subsection address coding for CAR-T cell therapy.
What is CAR-T cell therapy? It is an immunotherapy treatment for cancer, primarily those that affect the blood such as multiple myeloma and leukemia. CAR-T stands for chimeric antigen receptor. In a lab, this protein is added to a patient’s T cells enabling the body’s own immune system to target and fight the cancer cells. When the modified cells are reintroduced into the body, the CAR-T cells will bind to antigens on the cancer cells. This activates the T-cells to destroy the cancer cells.
The illustration below shows the process that a patient having CAR-T cell therapy will undergo. First, T-cells are harvested from the patient. At the lab, the cells are genetically modified and then replicated. The cells are then infused back into the patient where they perform the functions of binding to the cancer cells and then destroying them.
Source: https://www.civilsdaily.com/news/car-t-cancer-therapy/
The new codes in CPT for CAR-T cell encompass different aspects of the process.
38225 Chimeric antigen receptor T-cell (CAR-T) therapy; harvesting of blood-derived T lymphocytes for development of genetically modified autologous CAR-T cells, per day
38226 preparation of blood-derived T lymphocytes for transportation (eg, cryopreservation, storage)
38227 receipt and preparation of CAR-T cells for administration
38228 CAR-T cell administration, autologous
Note the collection code can only be assigned once per day, with the same being true for the administration code no matter how many units are administered.
There are several notes that precede the CAR-T codes. Coding professionals should review them before assigning any codes. This is especially true when the cells are being infused back into the patient. Note the following instructions:
Do NOT report the following with CAR-T cell administration:
Fluids used to administer the cells
Incidental hydration
Supportive medication (eg, steroids) concurrently administered
DO report
Hydration unrelated to CAR-T administration
Other medications unrelated to CAR-T administration (eg, antibiotics, opioids)
It will be necessary to use modifier 59 for hydration or other medication administration that would be unrelated to CAR-T cell administration in order to receive payment for those services.
Now, light has been shed on coding for CAR-T.
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