Reprinted from April 2003 CAP TODAY
Q: Which frozen section codes, 88331 and/or 88332, do I report if
the first specimen required one frozen section to confirm the adequacy
of the surgical margins and the second specimen required frozen sections
on two tissue blocks?
A: Use code 88331, pathology consultation during surgery; first
tissue block, with frozen section(s), single specimen, for the first frozen
section on the two specimens submitted separately. Use code 88332, Pathology
consultation during surgery; each additional tissue block with frozen
section(s), for the additional frozen section on the second specimen.
Based on the information provided, report two units of 88331 and one unit
Q: The word “only” has been added to code 38220 so that it now reads,
Bone marrow; aspiration only. Code 38221, Bone marrow; biopsy,
needle or tracor, has been indented beneath it. Do these changes affect
the way I should use the codes?
A: In CPT 2003, changes were made to the therapeutic apheresis
and bone marrow transplantation codes to reflect current clinical practices
and to create greater granularity to accurately describe the elements
of a procedure. Although the bone marrow codes were changed as part of
this effort, the intent of the revisions was not to change the established
use of these codes. The changes were made to better differentiate the
bone marrow biopsy codes from the bone marrow harvest procedure codes.
The word “only” was not added to prevent users from billing 38220 with
biopsy code 38221 when both procedures were performed but to differentiate
the codes from the bone marrow harvest procedures. The American Medical
Association’s CPT Changes 2003—An Insider’s View, (page 101),
explains the intent of the revision. For non-Medicare, continue to report
both codes when both procedures are performed.
Codes 38220 and 38221 are part of the Correct Coding Initiative edits
for the Medicare program. If both codes are submitted on the same day
for the same patient, the CCI edit program will deny the aspiration procedure
unless a modifier is used appropriately. When a physician performs a bone
marrow biopsy and aspiration through the same incision/puncture during
the same patient encounter, only code 38221 should be reported according
to the Centers for Medicare and Medicaid Services. Using the -59 modifier
with code 38220 to by-pass the CCI edit is only appropriate if the biopsy
and aspiration were performed on distinctly different anatomic sites or
if the two procedures were performed during different patient encounters
on the same date of service.
Frequently asked questions about CPT are published bimonthly in “Capitol
Scan.” This addition to CAP TODAY is a product of the CAP Economic
The codes and descriptions listed here are from Current Procedural Terminology,
a copyrighted publication of the American Medical Association. To purchase
CPT books, call the AMA at (800) 621-8335.