Neurosurgery Coding Alert

Question: When he performs spinal fusions, my neurosurgeon often performs a bone marrow aspiration to make a bone graft mixture. What code would I use to report this additional procedure?


Washington, D.C., Subscriber

Answer: Use 38220 (Bone marrow; aspiration only) for the bone marrow aspiration procedure if the neurosurgeon performs the aspiration through a separate skin puncture or fascial exposure, for example the iliac crest. If he aspirates the marrow from the local surgical site, such as the spine pedicle, you cannot separately report the aspiration procedure.

The other codes you may have looked at are 38221 (Bone marrow; biopsy, needle or trocar) and 38230 (Bone marrow harvesting for transplantation). Both of these are incorrect. You shouldn't use 38221 because the physician is not performing a biopsy. You shouldn't use 38230 because that code is reserved for a true bone marrow transplant (for cancer treatment, for example) and is not appropriate for aspirating bone marrow to use during a spinal fusion.