This is how we bill...
Medicare rule…..
As of January 1, 2005, Medicare created a new G-code (G0364) to report a bone marrow aspiration performed on the same date through the same incision as a bone marrow biopsy. G0364 is to be reported with the bone marrow biopsy code, 38221.
If the biopsy and aspiration are performed through different incisions or different patient encounters on the same day, then Medicare will make separate payments for each procedure. When billing for both the bone marrow aspiration (38220) and bone marrow biopsy (38221) codes on the same date of service, the -59 modifier is required. In these cases, the multiple procedure rule will apply and documentation in the medical record should support the billing.
Commercial payor rule…
When bone marrow aspiration is performed alone, the appropriate code to report is CPT code 38220. When a bone marrow biopsy is performed, the appropriate code is CPT code 38221 (bone marrow biopsy). CPT codes 38220 and 38221 may only be reported together if the two procedures are performed at separate sites or at separate patient encounters. Separate sites include bone marrow aspiration and biopsy in different bones or two separate skin incisions over the same bone. When both a bone marrow biopsy (CPT code 38221) and bone marrow aspiration (CPT code 38220) are performed at the same site through the same skin incision, only the bone marrow biopsy (CPT 38221) should be reported.