Effective January 1, 2018 the new CPT® code 38222 (Diagnostic bone marrow; biopsy (ies) and aspiration(s)) was created to combine two procedures into a single code. This was added to CPT text to simplify reporting when both procedures are performed.
Also effective January 1, 2018, codes 38220 and 38221 were revised to accommodate separate reporting and to reflect that both procedures are diagnostic procedures. Code 38220 notes that any number of aspirations are included as part of the procedure. For code 38221, the phrase “needle or trocar” was removed and the optional plural was added to indicate that any number of biopsies performed are included as part of the procedure.
38220 Diagnostic bone marrow; aspiration(s)
38221 Diagnostic bone marrow; biopsy (ies)
Do not report 38220 in conjunction with 38221
For diagnostic bone marrow biopsy [ies] and aspiration[s] performed at the same session, use 38222
38222 Diagnostic bone marrow; biopsy (ies) and aspiration(s)
Do not report 38222 in conjunction with 38220 and 38221
For bilateral procedures, report 38220, 38221, or 38222 with modifier 50
For bone marrow biopsy interpretation, use 88305
Documentation must support that the pathologist performed the procedure and whether it includes the biopsy, aspiration, or both.
Example:
1) A 60 year old male presents with peripheral blood pancytopenia with nondiagnostic iron studies and level B12. The patient requires both a bone marrow biopsy and aspiration.
The physician makes a small incision, inserts the bone marrow aspiration needle to the bone surface and drills the needle into the iliac crest marrow space. Bone marrow is aspirated. If necessary, the needle is placed again until adequate spicules are identified. Additional aspirates are obtained for cultures, flow, cytogenetics and molecular studies. Next, through the same incision a biopsy needle is introduced and a bone marrow biopsy is taken and assessed. If adequate, the needle is removed. Procedure complete.
CODE 38222
Reference AMA's Current Procedural Terminology (CPT) 2024.
