Resources & Education
Survival and quality-of-life have significantly improved for patients undergoing hematopoietic cell transplant (HCT) in recent years. HCT may be the best or only option for many patients with blood cancers and genetic disorders. Working with Payers and Transplant Centers, we have developed several educational resources to help you understand HCT and what to include as you design your benefits.
Explore the tools below and share with others who would benefit from this information.
Coding and Billing Resources
Our team works with many payers across the health care landscape. We maintain a robust reimbursement support resource center for transplant centers that contains useful information about coding and billing. This information may be useful to payers to understand how transplant centers are advised to code and subsequently bill for services. We provide this information to both payers and providers because billing for HCT is different from solid organ transplants in many ways.
The categories of payer information we provide includes:
Medicare – Including information regarding Medicare Coverage and Authorization, Cancelled Transplants, Rate-Setting and Billing.
Medicaid – Including information regarding Medicaid Coverage and Authorization, as well as the Prior Authorization Form.
Commercial – Including a sample Letter of Medical Necessity, Prior Authorization Form, and the Coverage Determination Checklist.
American Indian and Native Alaskan Coverage – Including resources regarding Indian Health Services (IHS) coverage.
And finally, general resources including clinical trials, appeals process and FAQs.
- Use this code sheet (PDF) to help plan for the implementation of the new ICD-10-PCS Coding System. The new system will require drastically different—and much more detailed—documentation for coders to report complete and accurate procedure codes.
- View an updated ICD-10 diagnosis code crosswalk to help coders report correctly in the new system.
- Learn about the HLA typing standards, costs, and coding (PDF) for the development of policies concerning joining the national registry.
- View an overview of new cord blood transplant regulations with the Payer's Guide to FDA Cord Blood Regulations (PDF).
- Download the Standardized Transplant Authorization Form (PDF) for Transplant Centers and Payers.
- This new resource outlines the Affordable Care Act (ACA)'s provisions around clinical trials access and provides a link to an American Society of Clinical Oncology (ASCO) form (PDF) that transplant centers can use with payers who may have questions about trial eligibility.
- Sign up for our e-news to stay up-to-date on new resources, events, and updates.
- The Jason Carter Clinical Trials Program makes it easier for patients and families to find and join clinical trials to treat blood cancers and blood disorders. Explore our web-based search tool to find relevant trials and educational information.
- On-demand CME activities: Addressing Clinical Challenges in AML (Webinars): Panelists use case studies to provide the latest research on key areas affecting clinical decision-making for patients with AML.
- On-demand CME: Improving Sickle Cell Disease Outcomes (Webinar): Sickle cell disease (SCD) experts explore treatment decision-making, curative therapies and strategies for overcoming barriers to patient care. A young adult share show she chose transplant as a cure for her SCD.
- Stem Cell Transplant and What You Need to Know (Recording) - held April 2015 by the Case Managers Society of America. This National Marrow Donor Program/Be The Match sponsored webinar, presented Dr. Dennis Confer, NMDP/Be The Match Chief Medical Officer, discusses HCT history and advancements.
- Healthcare Reform and Transplantation (PDF)—presented at the 2014 BMT Tandem Meetings, Michael Boo, Chief Strategy Officer, National Marrow Donor Program/Be The Match
- Impact of the Affordable Care Act on Stem Cell Transplantation (Full article available)
- Standardization of Terminology for Episodes of Hematopoietic Stem Cell Patient Transplant Care (PDF) - view recently published definitions for cell products, cell infusions, and transplantation episodes
- Access more clinical education programs and resources to stay up-to-date on the latest BMT advances in the Clinical section of BeTheMatchClinical.org
Contact us to learn more about our payer resources.