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Bone marrow aspirate and biopsy from the same site

N

ninchik

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8
Location
Marietta, GA
In the CPT Assistant
Year: 2015
Issue: March
Pages: 9
Title: Surgery: Musculoskeletal System
When a question was asked "When an oncologist performs a bone marrow aspirate and biopsy from the same site, may both the biopsy and aspirate be reported?"
The answer was given as an "Yes. Bone marrow aspiration and biopsy are performed with separate instruments and for different purposes. They are processed in different ways and interpreted by different individuals. Therefore, if procedures identified by codes 38220, Bone marrow; aspiration only, and 38221, Bone marrow; biopsy, needle or trocar, are both performed at the same site, each code may be reported."

Has anyone been successful in getting paid when billed together?
 
ninchik said:
In the CPT Assistant
Year: 2015
Issue: March
Pages: 9
Title: Surgery: Musculoskeletal System
When a question was asked "When an oncologist performs a bone marrow aspirate and biopsy from the same site, may both the biopsy and aspirate be reported?"
The answer was given as an "Yes. Bone marrow aspiration and biopsy are performed with separate instruments and for different purposes. They are processed in different ways and interpreted by different individuals. Therefore, if procedures identified by codes 38220, Bone marrow; aspiration only, and 38221, Bone marrow; biopsy, needle or trocar, are both performed at the same site, each code may be reported."

Has anyone been successful in getting paid when billed together?
Click to expand...

Hi, we bill both and don't have a problem. If it's Medicare, we use 38221 and G0364.
 
Adding to the information

Hi,

I'm taking the CHONC exam this weekend and my study guide says the following:

"When a bone marrow aspiration and biopsy are preformed during the same surgical encounter, code selection is determined by the sites of the procedure. According to National Correct Coding Initiative (NCCI), when a bone aspiration and bone marrow biopsy are preformed on the same site through the same skin incision, only report the bone marrow biopsy. If the procedures are preformed on separate sites or through separate incisions, both services are reported with 38221, 38220-59. Modifier 59 is appended to report that a distinct service was preformed.

If the patient is covered by Medicare and the aspiration and biopsy are preformed on the same site through the same incision, report 38221 and G0364.

Both procedures are minor procedures that have 0 global days. When preformed during a significant and separately identifiable E/M service, modifier 25 is appended to the E/M code."

Hope this clarifies that.
 
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