Wiki Bone marrow bx/aspiration ?

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cpccoder2008

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When billing medicare should you use G0364 for a bone marrow bx and aspiration ? Or should you use 38221 ? On another oncology forum someone stated they use G0364 and 38221 for all patients with -59. I don't think i agree with that. It seems that you would be double billing the patients. I'll paster that question also to see what other's think.


Thanks

We are having a discussion in our office regarding coding of bone marrow
biopsy and aspirate coding. My contention is that we should bill all
carriers G0364 (aspirate w/ biopsy) + 38221 biopsy when aspirate/biopsy
done at same site. The only time we would bill 38220 (aspirate only) +
38221 would be if aspirate done on left iliac crest and biopsy done on
the right or if aspirate was done at different anatomical site than the
biopsy.

U r correct
Plus there should be 59
 
Medicare's CCI manual, Chap V, E. Hemic and Lymphatic Systems indicates.....
Report both 38221 & G0364 for Bone Marrow Biopsy and Aspiration performed through the same skin incision, same date of service.

No modifier -59 necessary to my knowledge

In addition, CPT 38220 & 38221 may only be reported together when the procedures are performed during different encounters or separate sites...in this case you would append the appropriate modifier (i.e. -59) to CPT 38220.\
http://www.cms.hhs.gov/NationalCorrectCodInitEd/01_overview.asp#TopOfPage


Hope this helps,
 
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