december 2017

2018 CPT Code Changes

For 2018 there are not as many CPT code changes as in past years but there are a large number of editorial changes that will require the coder to read ALL of the parenthetical notes associated with your code selection.

One change I do want to discuss is in relation to CPT code 38220 – Bone marrow, aspiration only. This code is also used in spinal arthrodesis for the purposes of bone grafting. Because of the changes to code 38220, a new code was developed for use in arthrodesis procedures and that is add-on code 20939 – Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or fascial incision. This code is ONLY used for spine surgery and ONLY when the bone marrow is aspirated through a separate skin or fascial incision. For example, many physicians will aspirate bone marrow from the vertebral body which is then subsequently fused. In these instances when the bone marrow is aspirated at the surgical site, it would not be appropriate to report 20930.  When bone marrow is aspirated for grafting purposes in any other type of orthopedic procedure you should report unlisted CPT code 20999. Do not confuse this with aspiration for a PRP (platelet rich stem cell) injection in which you should still report Category III code 0232T.

CPT codes 38220/38221 have been revised as follows, 38220-Diagnostic bone marrow; aspiration(s) and 38221-biopsy(ies).  Note that both codes include the plural form of the word so single or multiple aspirations or biopsies are only reported one time using these codes. The 38220 aspiration is reported when bone marrow fluid is aspirated and the 38221 biopsy code is reported when a core of tissue/bone is removed. This leads us to the last code 38222-biopsy(ies) and aspiration(s) which is a new code in 2018 and represents a procedure where the physician has documented both the biopsy and aspiration procedures.





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