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Is it industry standards to bill 88305-26 x2 for bilateral bone marrow biopsies with two separate needle sticks? What about bilateral Bone Marrow Smear interpretations 85097-26 x2?
Pathology Report -
Gross Description
Specimen type: Right and Left iliac crest aspirate and biopsy
Particles: Few Clots: None
The right biopsy is 2.4 cm in aggregate length and appears red and white.
The left biopsy is 1.7 cm in aggregate length and appears red and white.
Adequacy: Satisfactory
Bone Marrow Microscopic Finding
Assessment is made from Wright-stained aspirate smears which are oligoparticulate. The M:E ratio is
3:1. The myeloid line matures normally and the erythroid line exhibits normal maturation. Blasts
account for 1% of the cells. Mature lymphocytes comprise 20% of the population. Megakaryocytes
are adequate in number. Multiple clusters of large cohesive cells are present in the right aspirate, c/w
neuroblastoma cells. There is no evidence of tumor cells in the left aspirate.
After fixation the right biopsy includes 1.4 cm and the left biopsy 1.3 cm of evaluable hematopoietic
marrow. The cellularity is ~80% on the right, and ~60% on the left. The right biopsy has tumor
infiltration that occupies ~40% of the marrow space on H&E stained sections. There is no tumor
infiltration identified in the left biopsy on H&E stained sections.
Procedural Report -
Procedure Note - Bone Marrow Aspirate and Biopsy
Diagnosis: Neuroblastoma
Following sedation with propofol and alfentanyl, the right iliac crest was prepped with
povidone-iodine with adherence to skin prep policy drying time. The patient was draped in sterile fashion. Lidocaine was placed
locally to the periosteum. An 15 gauge 1.5 inch disposable aspirate needle was placed into the site. Bone marrow was
aspirated and placed into an EDTA tube and sodium heparin tube without complication. Using the same technique, the
bone marrow aspiration was repeated on the contralateral iliac crest. The procedure was well tolerated.
The bone marrow core was obtained using a 13 gauge 2 inch disposable biopsy needle, then placed onto a
saline-moistened non-adherent dressing. Using the same technique, the bone marrow biopsy was repeated on the
contralateral iliac crest. The procedure was well tolerated. All solutions, medications, and syringes were labeled according
to labeling policy.
Is it industry standards to bill 88305-26 x2 for bilateral bone marrow biopsies with two separate needle sticks? What about bilateral Bone Marrow Smear interpretations 85097-26 x2?
Pathology Report -
Gross Description
Specimen type: Right and Left iliac crest aspirate and biopsy
Particles: Few Clots: None
The right biopsy is 2.4 cm in aggregate length and appears red and white.
The left biopsy is 1.7 cm in aggregate length and appears red and white.
Adequacy: Satisfactory
Bone Marrow Microscopic Finding
Assessment is made from Wright-stained aspirate smears which are oligoparticulate. The M:E ratio is
3:1. The myeloid line matures normally and the erythroid line exhibits normal maturation. Blasts
account for 1% of the cells. Mature lymphocytes comprise 20% of the population. Megakaryocytes
are adequate in number. Multiple clusters of large cohesive cells are present in the right aspirate, c/w
neuroblastoma cells. There is no evidence of tumor cells in the left aspirate.
After fixation the right biopsy includes 1.4 cm and the left biopsy 1.3 cm of evaluable hematopoietic
marrow. The cellularity is ~80% on the right, and ~60% on the left. The right biopsy has tumor
infiltration that occupies ~40% of the marrow space on H&E stained sections. There is no tumor
infiltration identified in the left biopsy on H&E stained sections.
Procedural Report -
Procedure Note - Bone Marrow Aspirate and Biopsy
Diagnosis: Neuroblastoma
Following sedation with propofol and alfentanyl, the right iliac crest was prepped with
povidone-iodine with adherence to skin prep policy drying time. The patient was draped in sterile fashion. Lidocaine was placed
locally to the periosteum. An 15 gauge 1.5 inch disposable aspirate needle was placed into the site. Bone marrow was
aspirated and placed into an EDTA tube and sodium heparin tube without complication. Using the same technique, the
bone marrow aspiration was repeated on the contralateral iliac crest. The procedure was well tolerated.
The bone marrow core was obtained using a 13 gauge 2 inch disposable biopsy needle, then placed onto a
saline-moistened non-adherent dressing. Using the same technique, the bone marrow biopsy was repeated on the
contralateral iliac crest. The procedure was well tolerated. All solutions, medications, and syringes were labeled according
to labeling policy.