# 38220 vx 38221 (Bone marrow asp & biopsy)



## cleecpc (Aug 27, 2008)

Could any one please help me? I have started a new position as coding coordinator for an oncology group. The billing specialists tell me they have always billed for 38220 (bone marrow;aspiration only) and 38221 (bone marrow;biopsy, needle or trocar) and gotten paid for both. 38220 is a component of 38221, so I contend that only the 38221 should be billed. 

The procedure note states "Patient was draped and prepped under local anesthetic with 1% lidocaine and bicarbonate. After informed consent, bone marrow was aspirated from the left posterior iliac crest. A bone marrow biopsy was then obtained from the posterior iliac crest and the specimen was sent for bone marrow aspirate and biopsy, flow cytometry and crtogenetics." 

What do you think??


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## TeresaV (Aug 27, 2008)

You can only bill a 38220 with a 38221 if the physician removes the needle after the aspiration is done and then places the needle back in at a different location to do the Biopsy. You have to use a 59 modifer to the 38220. If the physician does not mention that the needle was removed and then replaced your cpt codes should be G0364 and 38221.

Teresa K. Vaughn CPC,RCC


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## cleecpc (Sep 2, 2008)

Thanks for your help!


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