Orthopedic Coding Alert

Question: How should I report a bone biopsy, and how do I determine a superficial bone biopsy from a deep one?

Utah Subscriber

Answer: The code you’ll report for a bone biopsy will depend on the bone type and the depth of the biopsy. Here’s the codes for bone biopsy — pay attention to the descriptors, as we’ll discuss them again later:

• 20220 (Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs))
• 20225 (… deep (eg, vertebral body, femur))
• 20240 (Biopsy, bone, open; superficial (eg, sternum, spinous process, rib, patella, olecranon process, calcaneus, tarsal, metatarsal, carpal, metacarpal, phalanx))
• 20245 (… deep (eg, humeral shaft, ischium, femoral shaft))

Comparison codes: In order to report the correct code from the above, you should pay attention to the descriptors. If the biopsy is taken from an area that is listed in the codes as superficial — ilium, sternum, spinous process, ribs, sternum, rib, patella, etc. — then you would choose a superficial bone biopsy code. You should also code other bone biopsies of similar depths as superficial biopsies.

Further, if the biopsy is taken from an area that is listed in the code descriptors as deep — vertebral body, femur, humeral shaft, ischium, femoral shaft — then you would chose a deep bone biopsy code. You should also code other bone biopsies of similar depths as deep biopsies.