Coding/Billing Bone Marrow & Aspirations: 38220,38221,38222

Post here your questions regarding auditing ,coding, documentation, and compliance. Also, join in on the conversation- help your fellow auditors and compliance professionals in the industry.

Moderators: Shannon DeConda, NAMAS Moderator

Post Reply
fjohnson
Posts: 59
Joined: Wed Mar 13, 2013 9:04 am

Fri May 25, 2018 4:17 pm

In lieu of the new code, CPT 38222 , Diagnostic bone marrow, biopsy(ies) and aspiration(s), when would it be appropriate to bill 38220 (aspiration only) and 38221 (biopsy only) with a modifier 59?

Based on CPT Assistant May 2018 page 3 the following is stated:

Both codes 38220 and 38221 should not be reported for the same patient encounter for obtaining diagnostic bone material for pathologic testing.

This clarification seems to state that an aspiration & biopsy performed at the same patient encounter should never be reported together regardless of different anatomic site or incision. Is this interpretation correct?

Additionally, the assistant states the following:
Multiple diagnostic bone marrow aspirations and biopsies obtained at the same anatomic site may not be reported separately. If aspirations and biopsies are performed at different anatomic sites, modifier 59 should be appended to code 38222.

Could a clarification be given for this? Would you report 38222 performed at the same site with multiple units? How would the second scenario be reported?
Post Reply