Question from Clinical Coding Workout 2013, question 5.2

I have a question regarding bone marrow aspiration and biopsy. The diagnosis is iron deficiency anemia (280.9) and the doctor performed a bone marrow aspiration and biopsy which is stated in the pathology report. The correct answer for the procedure is only 38220, the aspiration. I don't understand why the biopsy is not coded. The explanation states that the "surgeon shows that the procedure performed was a bone marrow aspiration, bone trabecula not seen. Code 38221 for biopsy would not be coded." Since the pathology report states aspiration and biopsy why would the biopsy not be coded. Thank you.

re: Question from Clinical Coding Workout 2013, question 5.2

Per RandMedical states this:

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); this code cannot be reported with CPT® code 20220 (bone 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.