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,
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