Oncology & Hematology Coding Alert

Answer: You are trying to report a sequential bone marrow aspiration and biopsy. To decide the right code, you need clarity and documentation on the number of incisions and the specific sites involved. 

 

You have four different possible situations:

 

1 Your physician may do a bone marrow aspiration alone. In this case, the best code is 38220 (Bone marrow; aspiration only). 

2 When the physician performs only a bone marrow biopsy, you report code 38221 (Bone marrow; biopsy, needle or trocar).

3 Your physician may do a bone marrow aspiration and biopsy together (as is indicated in your question). You need to further confirm if the aspiration and biopsy were done at separate sites or in separate patient encounters. If so, you may report 38220 and 38221 together.

 

When do you report separate sites? You report aspiration and biopsy of bone marrow in separate sites when your physician attempts the two procedures in:

4 Your physician may do the bone marrow aspiration and biopsy at the same site through the same skin incision. In this case, you should not report 38220 in addition to 38221. Instead, you may report code G0364 (Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service) to describe the bone marrow aspiration performed with bone marrow biopsy.

 

Note: Medicare indicates you shouldn’t use modifier 59 to bill 38220 and 38221 together for a bone marrow biopsy and aspiration through the same incision.