Disease Subtype(s) HCT Disease Inserts Cellular Therapy Disease Inserts
  • Rheumatoid arthritis(603)
Form 2041 & 2141 No disease insert required
  • Psoriatic arthritis / psoriasis (604)
  • Juvenile idiopathic arthritis (JIA): systemic (Stills disease) (640)
  • JIA: oligoarticular (641)
  • JIA: polyarticular (642)
  • JIA: other (643)
  • Other arthritis (633)
Form 2042 & 2142 No disease insert required
  • Multiple sclerosis
Form 2043 & 2143 No disease insert required
  • Systemic sclerosis
Form 2044 & 2144 No disease insert required
  • Systemic lupus erythematosis (SLE) (605)
Form 2045 & 2145 No disease insert required
Connective tissue diseases
  • Sjögren syndrome (608)
  • Polymyositis / dermatomyositis (606)
  • Antiphospholipid syndrome (614)
  • Wegener granulomatosis (610)
  • Classical polyarteritis nodosa (631)
  • Microscopic polyarteritis nodosa (632)
  • Churg-Strauss (635)
  • Giant cell arteritis (636)
  • Takayasu (637)
  • Behcet syndrome (638)
  • Overlap necrotizing arteritis (639)
  • Other vasculitis (611)
Other neurologic autoimmune disease
  • Myasthenia gravis (601)
  • Other autoimmune neurological disorder (644)
Hematologic autoimmune disease
  • Idiopathic thrombocytopenic purpura (ITP) (645)
  • Hemolytic anemia (646)
  • Evan syndrome (647)
  • Other autoimmune cytopenia (648)
Bowel disease
  • Crohn’s disease (649)
  • Ulcerative colitis (650)
  • Other autoimmune bowel disorder (651)
No disease insert required No disease insert required

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