Medical Billing · Nationwide
Pediatric Hematology-Oncology & Cellular Therapy Medical Billing Services
Pediatric allogeneic and autologous stem cell transplants, FDA-approved CAR-T cell immunotherapy processing and infusion, diagnostic bone marrow harvests, intrathecal chemotherapy, and complex pediatric cytokine release syndrome critical care.
Aethera Healthcare Solutions provides full-service medical billing and revenue cycle management to pediatric oncologists, pediatric hematologists, cellular immunotherapy teams, and pediatric bone marrow transplant centers across the United States. We handle coding, claims, payment posting, denial management, and A/R follow-up end to end — so your team can stay focused on patient care while your revenue cycle runs cleanly.
Typical pediatric hematology-oncology & cellular therapy CPT range we work: 38205, 38206, 38240, 38241, 0537T, 0538T, 0539T, 0540T, 96450, 36561, 99291, 99292.
Why pediatric hematology-oncology & cellular therapy billing leaks revenue
CAR-T cellular therapy prior authorization denials: Payers rejecting autologous chimeric antigen receptor (CAR-T) therapy (CPT 0537T-0540T) due to rigid CD19+ relapsed/refractory pediatric ALL trial criteria documentation requirements
Stem cell processing unbundling rejections: Clearinghouses bundling allogeneic bone marrow harvesting (38205), cell processing/cryopreservation, and infusion (38240) into an arbitrary single-event payment
Intrathecal chemotherapy administration bundled with lumbar puncture: Denials of CPT 96450 (chemotherapy administration into CNS with lumbar puncture) when billed alongside routine pediatric sedation or bone marrow aspiration
Inpatient cytokine release syndrome (CRS) critical care downcoding: Downcoding of complex ICU critical care (99291/99292) during severe post-CAR-T neurotoxicity (ICANS) and tocilizumab/steroid titration
How Aethera fixes it
Specialty-trained coders (CPC/CCS) code to the documentation
First-pass claim scrubbing against payer and NCCI edits
Proactive denial prevention and 72-hour denial work
Relentless A/R follow-up to drive days-in-A/R down
Eligibility and prior-auth verification before service
Transparent, real-time reporting in the provider portal
Free tools for your billing team
Use these any time — no login required.
Pediatric Hematology-Oncology & Cellular Therapy billing FAQ
How are CAR-T cellular therapy procedures coded and reimbursed for pediatric patients?
CAR-T therapy involves multiple sequential phases: cell collection/leukapheresis (38206), preparation and laboratory processing (0537T, 0538T, 0539T), and autologous CAR-T cell infusion (0540T). In addition to professional procedure codes, the product itself is billed with HCPCS Q2042 (tisagenlecleucel, Kymriah) under an approved FDA REMS program. Prior authorization must be secured across all collection, laboratory manufacturing, and inpatient administration phases.
Can bone marrow aspiration (38220) and biopsy (38221) be billed during the same pediatric encounter as intrathecal chemo (96450)?
Yes. When performed under general anesthesia during pediatric leukemia restaging, CPT 38222 (diagnostic bone marrow biopsy and aspiration) and CPT 96450 (intrathecal chemotherapy via lumbar puncture) represent distinct anatomic sites and distinct procedures. Modifier 59 (or XE/XS) is appended to 96450 to reflect separate procedural intervention, and time spent on sedation cannot overlap with physician procedural time.