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Official Description

Photopheresis, extracorporeal

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Extracorporeal photopheresis (ECP), also known as extracorporeal photochemotherapy, is a specialized medical procedure that involves the treatment of certain blood and skin disorders. This technique is primarily utilized for patients suffering from cutaneous T-cell lymphoma (CTCL), various blood and bone marrow neoplasms, and individuals with chronic graft versus host disease (GVHD). The procedure begins with the establishment of venous access, which can be achieved through either a peripheral or central venous access line. Once access is secured, a specific volume of the patient's blood is drawn and subjected to leukapheresis, a process that separates white blood cells from the rest of the blood components. The number of cycles of leukapheresis performed, typically ranging from three to six, is determined based on the patient's hematocrit value and overall size. After each cycle, the red blood cells and plasma are reinfused back into the patient, ensuring that vital components of the blood are retained. The collected white blood cells are then treated with a mixture of heparin, saline, and a chemotherapeutic agent before being exposed to ultraviolet A (UVA) light. This exposure induces changes in the DNA of the lymphocytes, leading to the death of the treated T-cells. The final step involves reinfusing the treated white blood cell mixture back into the patient, which not only targets the abnormal cells but may also promote additional therapeutic effects against circulating abnormal blood cells that were not directly treated during the procedure.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure of extracorporeal photopheresis (ECP) is indicated for the treatment of specific medical conditions, particularly those involving abnormal blood cell proliferation or immune responses. The following conditions are explicitly mentioned as indications for ECP:

  • Cutaneous T-cell lymphoma (CTCL) - A type of cancer that affects the skin and is characterized by the proliferation of T-cells.
  • Other types of blood and bone marrow neoplasms - This includes various malignancies that originate in the blood or bone marrow.
  • Chronic graft versus host disease (GVHD) - A condition that can occur after a stem cell or bone marrow transplant, where the donated cells attack the recipient's body.

2. Procedure

The procedure of extracorporeal photopheresis involves several critical steps that ensure the effective treatment of the indicated conditions. Each step is designed to maximize the therapeutic benefits while ensuring patient safety.

  • Step 1: Establishing Venous Access - The first step in the ECP procedure is to establish venous access. This can be done using either a peripheral or central venous access line, which allows for the safe withdrawal of blood from the patient. The choice of access method depends on the patient's condition and the anticipated duration of the treatment.
  • Step 2: Blood Collection and Leukapheresis - Once venous access is secured, a specific volume of the patient's blood is drawn. This blood is then processed through a leukapheresis machine, which separates the white blood cells from the other blood components. The number of cycles of leukapheresis performed, typically ranging from three to six, is determined based on the patient's hematocrit value and overall size.
  • Step 3: Reintegration of Blood Components - At the end of each leukapheresis cycle, the red blood cells and plasma are reinfused back into the patient. This step is crucial to maintain the patient's blood volume and ensure that essential components are not lost during the procedure.
  • Step 4: Treatment of White Blood Cells - The collected white blood cells are then mixed with heparin, saline, and a chemotherapeutic agent. This mixture is prepared to enhance the effectiveness of the subsequent treatment.
  • Step 5: Ultraviolet A Light Exposure - The prepared mixture of white blood cells is exposed to ultraviolet A (UVA) light. This exposure induces changes in the DNA of the lymphocytes, leading to the death of the treated T-cells. This step is critical as it targets the abnormal cells that contribute to the patient's condition.
  • Step 6: Reinjection of Treated White Blood Cells - Finally, the treated white blood cell mixture is reinfused back into the patient. This reinfusion not only aims to eliminate the targeted abnormal cells but may also promote additional therapeutic effects against any circulating abnormal blood cells that were not directly treated during the procedure.

3. Post-Procedure

After the completion of the extracorporeal photopheresis procedure, patients may require monitoring for any immediate adverse reactions or complications. It is essential to observe the patient for signs of infection or any other side effects related to the venous access site. Additionally, patients may experience temporary fatigue or other mild symptoms following the treatment. The healthcare team will provide specific post-procedure care instructions, which may include hydration recommendations and follow-up appointments to assess the effectiveness of the treatment and monitor the patient's overall health. Continuous evaluation is crucial to determine the need for additional ECP sessions or alternative therapies based on the patient's response to treatment.

Short Descr PHOTOPHERESIS
Medium Descr PHOTOPHERESIS EXTRACORPOREAL
Long Descr Photopheresis, extracorporeal
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Procedure or Service, Not Discounted when Multiple
ASC Payment Indicator Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE 1
CCS Clinical Classification 231 - Other therapeutic procedures
Q0 Investigational clinical service provided in a clinical research study that is in an approved clinical research study
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
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
CR Catastrophe/disaster related
26 Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
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.
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
95 Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system.
AG Primary physician
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
GA Waiver of liability statement issued as required by payer policy, individual case
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
SA Nurse practitioner rendering service in collaboration with a physician
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
1990-01-01 Added First appearance in code book in 1990.
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