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Thread: Bone marrow bx/aspiration ?

  1. #1
    Join Date
    Apr 2007

    Default Bone marrow bx/aspiration ?

    AAPC: Back to School
    When billing medicare should you use G0364 for a bone marrow bx and aspiration ? Or should you use 38221 ? On another oncology forum someone stated they use G0364 and 38221 for all patients with -59. I don't think i agree with that. It seems that you would be double billing the patients. I'll paster that question also to see what other's think.


    We are having a discussion in our office regarding coding of bone marrow
    biopsy and aspirate coding. My contention is that we should bill all
    carriers G0364 (aspirate w/ biopsy) + 38221 biopsy when aspirate/biopsy
    done at same site. The only time we would bill 38220 (aspirate only) +
    38221 would be if aspirate done on left iliac crest and biopsy done on
    the right or if aspirate was done at different anatomical site than the

    U r correct
    Plus there should be 59

  2. #2


    Medicare's CCI manual, Chap V, E. Hemic and Lymphatic Systems indicates.....
    Report both 38221 & G0364 for Bone Marrow Biopsy and Aspiration performed through the same skin incision, same date of service.

    No modifier -59 necessary to my knowledge

    In addition, CPT 38220 & 38221 may only be reported together when the procedures are performed during different encounters or separate sites...in this case you would append the appropriate modifier (i.e. -59) to CPT 38220.\

    Hope this helps,
    Last edited by ciphermed; 10-19-2009 at 01:40 PM.
    Anthony McCallum, CPC, CIRCC, CPC-I, CCS

  3. #3
    Join Date
    Apr 2007


    Thank you,, i printed and gave to my physician. Thanks

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