Pathology/Lab Coding Alert

Choose 38220-59 or G0364 depending on surgical conditions. Whether you'll see Medicare pay for bone marrow and bone biopsy specimen extraction or evaluation depends on the four guidelines below. Beware: With Correct Coding Initiative (CCI) directives and a HCPCS twist, these guidelines will put your coding savvy to the test. Site or Encounter Guides Bone Marrow Extraction Coding Because a bone marrow biopsy allows the pathologist to assess cellularity and a bone marrow aspiration can provide enhanced cytologic detail, taking both specimens from the same patient on the same day to enhance diagnosis is not unusual, according to R.M. Stainton Jr., MD, president of Doctor's Anatomic Pathology in Jonesboro, Ark. Snag: Medicare and some other payers use the CCI edits to restrict how you bill for "sequenced" surgical procedures through the same incision. For bone marrow biopsy and aspiration, CCI bundles the following codes: • 38220 -- Bone marrow; aspiration only • [...]