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Neurosurgery Coding Alert

READER QUESTIONS:

Look at the Harvesting for 38220 and 20937, 20938

Published on Thu Nov 24, 2005

Question: Can 38220 be reported with 20937 or 20938 when both the graft and the bone marrow are obtained from the iliac crest?


Texas Subscriber
Answer: Whether you can report both 38220 (Bone marrow; aspiration only) with either 20937 (Autograft for spine surgery only [includes harvesting the graft]; morselized [through separate skin or fascial incision]) or 20938 (... structural, bicortical or tricortical [through separate skin or fascial incision]) depends on how your neurosurgeon harvests the bone marrow.

Typically, for neurosurgical grafting purposes, the physician removes the marrow in the course of a tricortical iliac crest graft, and you, therefore, would not be able to separately report the bone marrow aspiration and the graft.

If the neurosurgeon uses a needle, however, to aspirate additional marrow for grafting (or, less likely, he removes it through a separate incision), you could report it separately.
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