Billing and Coding: Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin

This article provides local billing/coding guidance that allogeneic hematopoietic cell transplantation is covered for patients with primary refractory or relapsed Hodgkin lymphoma and B- or T-cell non-Hodgkin lymphoma, consistent with CMS NCD 110.23 and LCD DL39434. Coverage requires documentation of a comprehensive pretransplant assessment (history, exam, labs, chest radiograph, ECG/cardiac function, PFTs, restaging, functional status, risk and comorbidity scoring such as EBMT and HCT-CI) and maintenance of records; pretransplant counseling (fertility preservation, advance care planning, informed consent) is suggested and should be documented.

"Allogeneic hematopoietic cell transplantation (HCT) is locally covered for patients with primary refractory or relapsed Hodgkin lymphoma or non-Hodgkin lymphoma of B-cell or T-cell origin, consiste..."

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