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Oncology & Hematology Coding Alert

Reader Question:

Bone Marrow Aspirate

Published on Mon Jan 01, 2001

Question: After reviewing the fourth quarter CCI edits, I cannot determine how to bill for bone marrow aspirations. Are we still unable to bill for it when performed with a bone marrow biopsy?

California Subscriber

Answer: Bone marrow aspirate (85095) is bundled into the bone marrow biopsy code (85102). An aspirate can be billed only when it is done by itself and not with the biopsy.

When a physician performs a bone marrow biopsy, an aspiration is performed as part of the procedure. CCI (6.3) identified 85102 as a comprehensive code, and 85095 is bundled as a component code. The CCI was implemented by HCFA to counteract the problem of unbundling that was occurring within the physician portion of the healthcare industry. Unbundling is the practice of breaking down a single valid procedure into smaller components for the purpose of billing for additional procedures.

This question was answered by Margaret Hickey, MS MSN, RN, OCN, CORLN, an independent coding consultant and former clinical director at Tulane Cancer Institute in New Orleans.
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