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Radiology Coding Alert

Reader Question:

38221 and G0364 Can Pair Up

Question: For private payers, should I report G0364 or 38220 for aspiration and biopsy at the same site and session?Illinois SubscriberAnswer: As is so often the case, you should get your payer's preference in writing and follow that instruction for that payer.In general terms, when the physician performs a bone marrow aspiration and biopsy at the same site during the same session, you should report 38221 (Bone marrow; biopsy, needle or trocar) for the biopsy. For the aspiration, you should add G0364 (Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service) if the private payer accepts that code. Or you instead may be able to report 38220 (Bone marrow; aspiration only) in addition to 38221 if the payer doesn't accept G0364.In contrast, if you're reporting to Medicare (or a payer that shares Medicare's rules), you should report both 38221 and G0364 to [...]

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