Billing Bone Marrow Aspiration/Biopsy

We are having a discussion in our office regarding coding for bone marrow
biopsy and aspirate performed same site. Should we bill all carriers G0364 (aspirate w/ biopsy) and 38221 biopsy when the aspirate and biopsy are performed at same site, or only bill Medicare this way? Would modifier -59 be appropriate to use with the above?

The only time we would bill both 38220 (aspiration) and 38221(biopsy) would be if aspiration was done on left iliac crest and biopsy was done on the right or if aspiration was done at different anatomical site than the biopsy.

Thanks in advance for any guidance in resolving our confusion.

Jane

re: Billing Bone Marrow Aspiration/Biopsy

In the CPT® book, 38221 is indented under 38220. This typically means that 38221 includes the work and materials of 38220, *plus* the Bx. The RVU(s) for the two codes confirm that (4.85 and 4.93 respectively from the last time I downloaded the RVU files). We do not bill the G0364 to non-Medicare payers because the latter - excluding Medicaid - allow more than Medicare.