Oncology & Hematology Coding Alert

READER QUESTIONS:

Watch for When G0364 Is Appropriate

 Question: Can I report both a bone marrow aspiration and a biopsy performed at the same site on the same day?
Massachusetts Subscriber

Answer: When your oncologist performs a bone marrow biopsy and an aspiration on the same site in the same session for a Medicare patient, you should report: 
 - 38221 -quot; Bone marrow; biopsy, needle or trocar
   - G0364 -quot; Bone marrow aspiration performed with
 bone marrow biopsy through the same incision on the
 same date of service.

 You don't need to use G0364 for insurers other than Medicare, unless they recognize the code.
 If the oncologist performs a bone marrow aspiration only, you should report 38220 (Bone marrow; aspiration only). And if the oncologist only takes a bone marrow biopsy, report 38221.
  Caution: If the oncologist performs a bone marrow biopsy on one anatomic site or during one session, and a bone marrow aspiration on another site or during another session, you should report the following:
  - 38221 for the biopsy
   - 38220 for the aspiration
   - modifier 59 (Distinct procedural service) with 38220 to show that the aspiration was a separate procedure (separate anatomic site or different patient encounter) from the biopsy.

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