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• W2005209930 abstract "Cellular therapies for critical limb ischemia (CLI) have been shown in multiple reports to improve perfusion and limb salvage where patients were deemed unsuitable for conventional therapy. The procedure which involves bone marrow aspirate for CLI requires a comprehensive understanding of vascular disease to allow for appropriate patient selection, preprocedure planning, intraoperative marking, and delivery of the cellular concentrate in a perivascular space under continuous ultrasound guidance. The clinical trials to date, in the majority of patients, have the bone marrow aspiration performed by a hematologist. The remainder of the service description is performed by the vascular specialist. However, some centers prefer that one individual does both the bone marrow aspiration as well as the injection therapy. Currently, there are no descriptions in the CPT manual appropriate for reporting this novel technique. Therefore, unless an insurance carrier indicates otherwise, the unlisted vascular procedure CPT code (37799) is most appropriate for all or part of this intervention. This will require submission of medical records and be subject to review by a medical director. On January 1, 2011, a new set of three Category III CPT codes were released for implementation on July 1, 2011. Category III CPT codes (also called “T” codes) are created for emerging technology that has not yet obtained approval from the U.S. Food and Drug Administration (FDA). As with the majority of Category III codes, they will undoubtedly be valued at $0 in the Medicare Physician's Fee Schedule, although regional carriers may choose to reimburse on a case-by-case basis. Once FDA-approval is achieved, conversion to Category I status will soon follow. CPT code 0263T states “Intramuscular autologous bone marrow cell therapy, with preparation of harvested cells, multiple injections, one leg, including ultrasound guidance, if performed; complete procedure including unilateral or bilateral bone marrow harvest.” This describes the entire procedure when both the bone marrow aspiration as well as the subsequent injection is accomplished by a single practitioner. The next two codes each describe a portion of the service. They are only appropriate for submission to the insurance carrier when an individual completes only that described segment of the operation. CPT code 0264T (“Intramuscular autologous bone marrow cell therapy, with preparation of harvested cells, multiple injections, one leg, including ultrasound guidance, if performed; complete procedure excluding bone marrow harvest”) encompasses all aspects of the procedure except the retrieval of bone marrow from either one or both iliac crests. Lastly, CPT code 0265T (“Intramuscular autologous bone marrow cell therapy, with preparation of harvested cells, multiple injections, one leg, including ultrasound guidance, if performed; unilateral or bilateral bone marrow harvest only for intramuscular autologous bone marrow cell therapy”) describes unilateral or bilateral bone marrow harvest specifically in conjunction with bone marrow aspiration/injection for CLI. There are several other Category I CPT codes that address procurement of bone marrow. The creation of these new Category III codes ensures that none of those other bone marrow harvest codes are appropriate to report when performed in this setting." @default.
• W2005209930 created "2016-06-24" @default.
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• W2005209930 date "2011-06-01" @default.
• W2005209930 modified "2023-09-30" @default.
• W2005209930 title "Autologous bone marrow mononuclear cell therapy is safe and promotes amputation-free survival in patients with critical limb ischemia" @default.
• W2005209930 doi "https://doi.org/10.1016/j.jvs.2011.04.020" @default.
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