Anthem Blue Cross and Blue Shield New Hampshire policy
TRANS.00023 Hematopoietic Stem Cell Transplantation for Multiple Myeloma and Other Plasma Cell Dyscrasias
TRANS.00023 Hematopoietic Stem Cell Transplantation for Multiple Myeloma and Other Plasma Cell Dyscrasias is a public Anthem Blue Cross and Blue Shield New Hampshire policy (policy TRANS.00023). It lists 19 CPT or HCPCS codes, 19 of them on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage decision; the payer's own document governs.
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- Policy number
- TRANS.00023
- Line of business
- Commercial
- Source
- www.anthem.com
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes. Prior authorization status is from the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list.
| Code | Prior authorization | Description on the prior authorization list | Other Anthem Blue Cross and Blue Shield New Hampshire policies |
|---|---|---|---|
| 38204 | On the list | Management of recipient hematopoietic progenitor cell donor search and cell acquisition | Policies naming 38204 |
| 38205 | On the list | Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic | Policies naming 38205 |
| 38206 | On the list | Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous | Policies naming 38206 |
| 38207 | On the list | Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage | Policies naming 38207 |
| 38208 | On the list | Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, without washing, per donor | Policies naming 38208 |
| 38209 | On the list | Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, with washing, per donor | Policies naming 38209 |
| 38210 | On the list | Transplant preparation of hematopoietic progenitor cells; specific cell depletion within harvest, T-cell depletion | Policies naming 38210 |
| 38211 | On the list | Transplant preparation of hematopoietic progenitor cells; tumor cell depletion | Policies naming 38211 |
| 38212 | On the list | Transplant preparation of hematopoietic progenitor cells; red blood cell removal | Policies naming 38212 |
| 38213 | On the list | Transplant preparation of hematopoietic progenitor cells; platelet depletion | Policies naming 38213 |
| 38214 | On the list | Transplant preparation of hematopoietic progenitor cells; plasma (volume) depletion | Policies naming 38214 |
| 38215 | On the list | Transplant preparation of hematopoietic progenitor cells; cell concentration in plasma, mononuclear, or buffy coat layer | Policies naming 38215 |
| 38230 | On the list | Bone marrow harvesting for transplantation; allogeneic | Policies naming 38230 |
| 38232 | On the list | Bone marrow harvesting for transplantation; autologous | Policies naming 38232 |
| 38240 | On the list | Hematopoietic progenitor cell (HPC); allogeneic transplantation per donor | Policies naming 38240 |
| 38241 | On the list | Hematopoietic progenitor cell (HPC); autologous transplantation | Policies naming 38241 |
| 38243 | On the list | Hematopoietic progenitor cell (HPC); HPC boost | Policies naming 38243 |
| S2142 | On the list | Cord blood-derived stem-cell transplantation, allogeneic | Policies naming S2142 |
| S2150 | On the list | Bone 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 posttransplant care in the global definition | Policies naming S2150 |
All Anthem Blue Cross and Blue Shield New Hampshire policies · Anthem Blue Cross and Blue Shield New Hampshire prior authorization CPT list