Pathology/Lab Coding Alert
Bone Marrow Aspiration and Biopsy
Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: The hematologist performs bone marrow aspiration and biopsy, and the pathologist reads the peripheral smears, marrow aspirate smears, and biopsy and clot sections. Iron stains are performed on aspirate smears, core biopsy sections and clot sections. How should the pathology charges be coded? Do we code separately for biopsy and clot sections? Do we code for one iron stain or three? If the biopsy is bilateral, should we double all the marrow charges?
Justin Sedlak
Trover Clinic, Madisonville, Ky.
According to an article in the July 1998 CPT Assistant , the interpretation of smears from the bone marrow aspiration is coded 85097, in addition to the bone marrow biopsy code, if both services are provided. If cell blocks also are prepared from the aspirate and clot, a separate 88305 (surgical pathology, gross and microscopic examination; cell block, any source) is coded for each cell block.
Because the unit of service for pathology is the specimen, if two bone marrow biopsies are identified from different locations (e.g., bilateral), they would be coded separately.
Special stains, such as an iron stain (88313), should be coded per specimen stained, regardless of the number of slides. The special stain codes are add-on codes and you should list separately in addition to code for surgical pathology examination, according to CPT 2000.
Editors note: Laurie Castillo, MA, CPC,president of American Association of Professional Coders Northern Virginia Chapter and owner of Physician Coding & Compliance Consulting in Manassas, Va., and Stacey Hall, ART, CPC, CCS-P, Medical Management Professionals Inc., a billing firm for physicians in Knoxville, Tenn., provided the answer to You Be the Coder.
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