Health Information Management

Facilities may report G0364 for bone marrow aspiration

APCs Insider, April 15, 2005

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Facilities may report G0364 for bone marrow aspiration

QUESTION: Could you please provide an update regarding HCPCS code G0364 (Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service)? Can facilities report this code?

ANSWER: In the August 2004 Physician Fee Schedule Proposed Rule, CMS proposed a new code (G000X, Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of services). A physician reports CPT code 38221 (bone marrow biopsy) and G0364 for the second bone marrow aspiration if performed through the same site.

Additional information and comments on the creation of this HCPCS G code can be found on page 66280 of the 2005 Physican Fee Schedule Final Rule, published in the November 15, 2004, Federal Register.

The primary use of the bone marrow code is for a physician service; however, the technical or hospital side should report it as well. This issue was addressed in the Physician Fee Schedule Final Rule. When speaking with CMS, it was noted that CMS does not crosswalk every issue that could affect both physician and hospital reimbursement methodologies. Review your CDM with your HIM professional coding staff regarding bone marrow aspiration and biopsy of the same site.

Here's how to report the code using the example of a left sided posterior iliac crest bone marrow aspiration and biopsy.

Operative Report: The left posterior iliac crest was prepped and draped in a sterile manner. 2% Lidocaine without Epinephrine was used for local anesthesia control. The left posterior iliac crest was approached and aspirate samples obtained. Through the same entry site, two separate core biopsy samples were obtained. The patient tolerated the procedure well.

The appropriate code assignments for the above example are 38221 and G0364. If you perform the aspiration in a different site than the posterior iliac crest, report 38221 and 38220-59.



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