The following is excerpted from the current National Correct Coding Policy Manual for Part B Medicare Carriers. This new CCI edit prohibits the coding of bone marrow aspiration and bone marrow biopsy when performed through the same skin incision on the same patient.
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.
The National Correct Coding Policy Manual for Part B Carriers can be found at http://www.cms.hhs.gov/physicians/cciedits/nccmanual.asp.