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2025 CPT code 38221

Bone marrow biopsy for diagnostic purposes.

Code 38221 is reported only once per day, regardless of the number of biopsies taken.

Medical necessity for a bone marrow biopsy is established by the presence of signs, symptoms, or laboratory findings suggestive of a condition that can be diagnosed or managed with information obtained from the bone marrow sample.

IMPORTANT:Do not report 38221 with 38220 (bone marrow aspiration). For diagnostic bone marrow biopsy and aspiration performed at the same session, use 38222.

In simple words: A small sample of bone marrow is taken from the breastbone or hip bone to be tested. This is done to help diagnose certain medical conditions.

The procedure involves collecting a small sample of bone marrow from the sternum or iliac crest for diagnostic testing. The physician prepares and anesthetizes the patient, and then inserts a trocar or makes a small incision to access the bone. A small amount of bone marrow is collected for analysis and the incision is closed with sutures or adhesive strips.

Example 1: A patient presents with unexplained anemia, and a bone marrow biopsy is performed to evaluate for possible causes such as leukemia or aplastic anemia., A patient with lymphoma undergoes a bone marrow biopsy to determine the extent of disease involvement (staging)., A patient with abnormal blood counts and suspected myeloma has a bone marrow biopsy to confirm the diagnosis.

Documentation should include the reason for the biopsy, the site of the biopsy, any complications encountered, and the results of the pathological analysis.

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