Wiki G0364 and 38221 Bone marrow aspiration and biopsy

[Missy13]

I am trying to find out if G0364 and 38221 can still be billed together to Medicare? How about commercial insurance?
What if only aspiration was done? Or if only biopsy was done?

All the information I am finding is a little old and I am not sure if anything has changed since.

Any help on this would be greately appreciated! Thanks.

 

[Missy13]

Found it - NCCI Policy Manual Cahpter 5

E. Hemic and Lymphatic Systems
1. When bone marrow aspiration is performed alone, the appropriate code to report is CPT code 38220. When a bone marrow biopsy is performed, the appropriate code is CPT code 38221 (bone marrow biopsy). This code cannot be reported with CPT code 20220 (bone biopsy). CPT codes 38220 and 38221 may only be reported together if the two procedures are performed at separate sites or at separate patient encounters. Separate sites include bone marrow aspiration and biopsy in different bones or two separate skin incisions over the same bone. When both a bone marrow biopsy (CPT code 38221) and bone marrow aspiration (CPT code 38220) are performed at the same site through the same skin incision, do not report the bone marrow aspiration, CPT code 38220, in addition to the bone marrow biopsy (CPT code 38221). HCPCS/CPT code G0364 may be reported to describe the bone marrow aspiration performed with bone marrow biopsy through the same skin incision on the same date of service.

 

[Loan K Vo]

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E. Hemic and Lymphatic Systems
1. When bone marrow aspiration is performed alone, the appropriate code to report is CPT code 38220. When a bone marrow biopsy is performed, the appropriate code is CPT code 38221 (bone marrow biopsy). This code cannot be reported with CPT code 20220 (bone biopsy). CPT codes 38220 and 38221 may only be reported together if the two procedures are performed at separate sites or at separate patient encounters. Separate sites include bone marrow aspiration and biopsy in different bones or two separate skin incisions over the same bone. When both a bone marrow biopsy (CPT code 38221) and bone marrow aspiration (CPT code 38220) are performed at the same site through the same skin incision, do not report the bone marrow aspiration, CPT code 38220, in addition to the bone marrow biopsy (CPT code 38221). HCPCS/CPT code G0364 may be reported to describe the bone marrow aspiration performed with bone marrow biopsy through the same skin incision on the same date of service.

This is perfect explanation and trusted source.

 

[jbrandt]

Hi,
Effective January 1st, 2018 a new combination CPT code was introduced when both an aspiration & biopsy are done at the same time, same incision. It's 38222 (diagnostic bone marrow; aspiration(s) & biopsie(s). Effective January 1st, 2018 CPT G0364 has been deleted (at least by our MAC carrier, I'd suggest you verify with your own MAC whether they've deleted it or not). So if only an aspiration is done, report 38220 & if only a biopsy is done report 38221. If both are done, report the new combination code of 38222. Hope this helps!