CPT® Code 36522

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.