Bone Marrow Performed by Pathologist

jdavenport02

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Our pathologist is planning on performing bone marrow biopsies. I am a little confused as to what CPT codes should be billed.

38220 - Aspiration only
38221 - Biopsy

1 - Does CPT code 38221 include the biopsy and aspiration or can you bill both if both are performed?

2 - If the patient has Medicare and would normally bill CPT code 38220, that should be changed to G0364, correct?

Any help is greatly appreciated!
:)
 

bbooks

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On very rare occasions our pathologists will also do the bone marrow biopsy. My experience with coding this is not extensive, but I reviewed Padget's before answering.

1. You can code for both procedures if your pathologist performs both.

2. Yes, IF the aspiration is done from the SAME entry point as the bone marrow biopsy. So, in this case you would code 38221, G0364. If the biopsy and the aspiration were done on SEPARATE sites, code 38221, 38220-59.

I hope this helps!
 

danachock

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Bone Marrow Biopsy - Pathology coding

Hi
The codes you have provided indicate that you are coding the procedure - the person that is extracting the bone marrow to have the pathology done. Nothing has been processed at this time. Only obtained to be processed.
The pathology charges you are looking for will be determined based on how your pathology team processes the specimen(s).

For example where I work this would be a routine bone marrow pathology.

Peripheral Smear 85060
Bone Marrow Smear 85097
Clot Biopsy 88305
Core Biopsy 88305
Decalcify 88311
Stain 88313

Thanks,
Dana Chock
Anesthesia, Pathology, & Laboratory Coder
2013/14 Brainerd AAPC Chapter President
 

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Darlene

Hi
The codes you have provided indicate that you are coding the procedure - the person that is extracting the bone marrow to have the pathology done. Nothing has been processed at this time. Only obtained to be processed.
The pathology charges you are looking for will be determined based on how your pathology team processes the specimen(s).

For example where I work this would be a routine bone marrow pathology.

Peripheral Smear 85060
Bone Marrow Smear 85097
Clot Biopsy 88305
Core Biopsy 88305
Decalcify 88311
Stain 88313

Thanks,
Dana Chock
Anesthesia, Pathology, & Laboratory Coder
2013/14 Brainerd AAPC Chapter President
HI Dana, Pathology codes for bone marrow processing; The codes you listed are the same ones that our pathology uses. However, the CCN does not want to pay anything except the 85097. They have denied the 88305 and 88311. They only paid one of the 88313, and our pathologist uses 2 of the 88313. They also do not pay the 85060. Can you give me advise on how or if these can get paid? As far as I know only the CCN's are denying these.

Thanks,
Linda East
SLMA Coder
 

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Darlene

Our Pathologist does not extract the bone marrow. That is done by the Oncology/Hematology doctor.
 
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