nyyankees
True Blue
Can a bone marrow aspiration be reported multiple times if done from multiple sites or is 38220 only reported 1x not matter how many sites are used for aspiration?
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki Bone Marrow Aspiration
- Thread starter nyyankees
- Start date
RebeccaWoodward*
True Blue
38220 can be reported more than once for a separate, distinct location. Example: The sternum and the iliac.
mdgiddens
New
2017 claims denials for 38220
anyone else out there getting denials on 2017 claims for 38220,59 performed during spinal fusions. HELP I know the code changed to 20939 in 2018, but prior to that my ortho surgeon had been getting paid. I need information for and argument to appeal these claims.
Thanks.
anyone else out there getting denials on 2017 claims for 38220,59 performed during spinal fusions. HELP I know the code changed to 20939 in 2018, but prior to that my ortho surgeon had been getting paid. I need information for and argument to appeal these claims.
Thanks.
As per 2017 NCCI Policy Manual, Chapter 4, page 9; A bone marrow aspiration (CPT code 38220) should not be reported separately with a spinal osteotomy, vertebral fracture repair, spinal arthrodesis, spinal fusion, laminectomy, spinal decompression, or vertebral corpectomy CPT code if the bone marrow aspiration is obtained from the surgical field. However, if the bone marrow aspiration is obtained from an anatomic site other than vertebrae on which the orthopedic/neurosurgical procedure is performed, it may be reported separately with an NCCI-associated modifier.
Effective January 1, 2018 and with the introduction of the new CPT code 20939 Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or fascial incision (List separately in addition to code for primary procedure), the 2018 revision of the NCCI Policy Manual was updated to CPT code 38220 describes diagnostic bone marrow aspiration(s). It shall not be reported separately with musculoskeletal procedures (e.g., spinal osteotomy, vertebral fracture repair, spinal arthrodesis, spinal fusion, laminectomy, spinal decompression, vertebral corpectomy), for bone marrow aspiration for platelet rich stem cell injection or other therapeutic musculoskeletal applications.
For procedures performed in 2017, claims should still be adjudicated following the the 2017 CPT and NCCI coding policies. Obviously, for claims submitted for procedures performed on or after 01/01/2018 the new CPT and NCCI coding policies will be used. As with the other Bone Graft Codes, BMA should only be reported once per surgical session.
William Sukovich, MD
Senior Medical Director Spine Surgery
Effective January 1, 2018 and with the introduction of the new CPT code 20939 Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or fascial incision (List separately in addition to code for primary procedure), the 2018 revision of the NCCI Policy Manual was updated to CPT code 38220 describes diagnostic bone marrow aspiration(s). It shall not be reported separately with musculoskeletal procedures (e.g., spinal osteotomy, vertebral fracture repair, spinal arthrodesis, spinal fusion, laminectomy, spinal decompression, vertebral corpectomy), for bone marrow aspiration for platelet rich stem cell injection or other therapeutic musculoskeletal applications.
For procedures performed in 2017, claims should still be adjudicated following the the 2017 CPT and NCCI coding policies. Obviously, for claims submitted for procedures performed on or after 01/01/2018 the new CPT and NCCI coding policies will be used. As with the other Bone Graft Codes, BMA should only be reported once per surgical session.
William Sukovich, MD
Senior Medical Director Spine Surgery
mdgiddens
New
38220 prior to 01/01/2018
Thank you for you reply
Thank you for you reply