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Code Deleted. See 38225, 38226, 38227, 38228.

Official Description

Chimeric antigen receptor T-cell (CAR-T) therapy; CAR-T cell administration, autologous

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Chimeric antigen receptor T-cell (CAR-T) therapy is a form of immunotherapy that harnesses the power of the patient's own immune system to combat cancer. This innovative treatment involves the extraction of the patient's white blood cells, specifically lymphocytic T-cells, which play a crucial role in the immune response. The process begins with the collection of these T-cells from the patient's blood, which may take place over one or more days. Once collected, the T-cells are genetically modified in a laboratory setting using a disarmed virus. This virus is engineered to introduce specific genetic material into the T-cells, enabling them to produce chimeric antigen receptors (CARs) on their surface. These CARs are designed to recognize and bind to particular protein antigens found on the surface of cancer cells, thereby enhancing the T-cells' ability to identify and attack malignant cells. After the T-cells have been successfully modified to express CARs, they are expanded and multiplied to create a substantial population, often numbering in the hundreds of millions. Concurrently, the patient undergoes lymphocytic cell-depleting chemotherapy to prepare their immune system for the subsequent infusion of the engineered T-cells. Once the CAR-T cells are ready and the patient is adequately prepared, the modified T-cells are infused back into the patient's bloodstream. Upon reintroduction, these CAR-T cells seek out and bind to the cancer cells, initiating a targeted immune response that leads to the destruction of the cancerous cells. The CAR-T cells can persist in the body for an extended period, providing ongoing surveillance and defense against potential cancer recurrence.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The indications for CAR-T therapy are primarily focused on specific types of cancers where traditional treatments may be less effective. This therapy is typically indicated for patients with:

  • Relapsed or Refractory B-cell Acute Lymphoblastic Leukemia (ALL) - This condition occurs when the cancer returns after treatment or does not respond to standard therapies.
  • Relapsed or Refractory Large B-cell Lymphoma - This includes various aggressive forms of non-Hodgkin lymphoma that have not responded to previous treatments.
  • Chronic Lymphocytic Leukemia (CLL) - CAR-T therapy may be indicated for patients with CLL that has not responded to other treatment options.

2. Procedure

The procedure for CAR-T therapy involves several critical steps that ensure the effective modification and reinfusion of the patient's T-cells. The steps are as follows:

  • Step 1: Blood Collection - Blood is drawn from the patient, typically through a process called apheresis, which separates the T-lymphocytes from other blood components. This process may take place over one or more days to collect an adequate number of T-cells for modification.
  • Step 2: T-cell Modification - The collected T-lymphocytes are sent to a specialized laboratory where they are genetically engineered. An inactive virus is introduced into the T-cells, which carries the genetic instructions to produce chimeric antigen receptors (CARs) on the T-cells' surface. This modification enables the T-cells to recognize specific antigens present on cancer cells.
  • Step 3: T-cell Expansion - After the T-cells have been modified, they are cultured and expanded in the laboratory. This process multiplies the number of CAR-T cells to hundreds of millions, ensuring a robust immune response upon reinfusion.
  • Step 4: Lymphodepleting Chemotherapy - While the CAR-T cells are being manufactured, the patient receives lymphocytic cell-depleting chemotherapy. This treatment reduces the number of existing lymphocytes in the patient's body, creating a more favorable environment for the newly infused CAR-T cells to thrive.
  • Step 5: CAR-T Cell Infusion - Once the CAR-T cells are ready and the patient has completed the preparatory chemotherapy, the modified T-cells are infused back into the patient's bloodstream. This infusion allows the CAR-T cells to circulate and seek out cancer cells.

3. Post-Procedure

After the CAR-T cell infusion, patients are closely monitored for any potential side effects and complications, which can include cytokine release syndrome (CRS) and neurological effects. The duration of monitoring may vary based on the patient's response and any adverse reactions. Patients may also require supportive care to manage symptoms and ensure recovery. The CAR-T cells can remain active in the body for an extended period, providing ongoing surveillance against cancer recurrence. Follow-up appointments are essential to assess the effectiveness of the therapy and to monitor the patient's overall health and response to treatment.

Short Descr CAR-T CLL ADMN AUTOLOGOUS
Medium Descr CAR-T THERAPY AUTOLOGOUS CELL ADMINISTRATION
Long Descr Chimeric antigen receptor T-cell (CAR-T) therapy; CAR-T cell administration, autologous
Status Code Carriers Price the Code
Global Days YYY - Carrier Determines Whether Global Concept Applies
PC/TC Indicator (26, TC) 9 - Not Applicable
Multiple Procedures (51) 9 - Concept does not apply.
Bilateral Surgery (50) 9 - Concept does not apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 9 - Concept does not apply.
Co-Surgeons (62) 9 - Concept does not apply.
Team Surgery (66) 9 - Concept does not apply.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Procedure or Service, Not Discounted when Multiple
Berenson-Eggers TOS (BETOS) none
MUE Not applicable/unspecified.
KX Requirements specified in the medical policy have been met
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
FS Split (or shared) evaluation and management visit
GC This service has been performed in part by a resident under the direction of a teaching physician
GZ Item or service expected to be denied as not reasonable and necessary
KY Dmepos item subject to dmepos competitive bidding program number 5
LU Fractionated payment
Q0 Investigational clinical service provided in a clinical research study that is in an approved clinical research study
SA Nurse practitioner rendering service in collaboration with a physician
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
Date
Action
Notes
2024-12-31 Deleted Code Deleted. See 38225, 38226, 38227, 38228.
2019-01-01 Added Added
Code
Description
Code
Description
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