Take This Advice to Accurately Report Bone Marrow Specimen Codes
Question: When we get bone marrow specimens from surgical procedures, the surgeon usually sends them as either a biopsy or an aspiration. Today, we got both from a single procedure. How is this coded? Revenue Cycle Insider Subscriber Answer: Bone marrow biopsies and bone marrow aspirations are two different procedures to remove fluid and cellular material from the spongy, semi-solid tissue located inside the bone for analysis. Bone marrow aspirations use a fine-gauge needle to withdraw a specimen of fluid and cells, while bone marrow biopsies use a larger-bore hollow needle to withdraw a core of bone marrow tissue. Bone marrow biopsies and aspiration specimens can provide different diagnostic information for certain conditions, so taking both specimens from the same patient on the same day isn’t unusual. If your pathologist examines both a biopsy specimen and an aspiration, you should report both 88305 (Level IV - Surgical pathology, gross and microscopic examination … Bone marrow, biopsy …) and 85097 (Bone marrow, smear interpretation). As you say, the surgeon should clearly state the specimen type. But the surgeon’s procedure code can also give you a clue to what they did, informing your biopsy and aspiration code choice. You can cross-reference your own lab coding with the following biopsy and/or aspiration surgical codes: Don’t forget: Pathologists often prepare and evaluate a cell block from a bone marrow aspiration specimen. If you see a cell block documented in the pathology report, you should report an additional unit of 88305 (… Cell block, any source …). For a bone marrow biopsy, the pathology report might also mention decalcification of the biopsy specimen. If you see decalcification referenced, you should additionally report +88311 (Decalcification procedure (List separately in addition to code for surgical pathology examination)). Bruce Pegg, BA, MA, CPC, CFPC, Managing Editor, AAPC
