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2025 CPT code 38222

Diagnostic bone marrow biopsy and aspiration.

Code 38222 includes both the aspiration and biopsy procedures. Report only once per encounter, even if multiple samples are taken from the same site.

Modifier 50 is applicable for bilateral procedures. Modifier 59 may be necessary to indicate distinct procedural services if performed at different sites.

Medical necessity for this procedure is established by the clinical indication for performing a bone marrow examination. This may include evaluating various hematologic or oncologic conditions, staging cancers, or investigating unexplained cytopenias.

The physician performs both a bone marrow aspiration and biopsy, typically from the iliac crest (hip bone) or sternum (breastbone). This involves inserting a needle to withdraw fluid and a trocar to obtain a tissue sample. Samples are then sent for analysis.

IMPORTANT:Do not report 38222 with 38220 (bone marrow aspiration) or 38221 (bone marrow biopsy). If aspiration and biopsy are performed at different locations, report 38220 and 38221 separately. For bilateral procedures, use modifier 50 with 38222.

In simple words: This procedure involves taking a sample of bone marrow for diagnostic testing through both needle aspiration (drawing out fluid) and biopsy (taking a small tissue sample).

This code represents a diagnostic bone marrow procedure that includes both biopsy(ies) and aspiration(s). It is used when both procedures are performed on the same bone during the same encounter.

Example 1: A patient with newly diagnosed leukemia needs both a bone marrow aspirate and biopsy to confirm the diagnosis and determine the specific type of leukemia., A patient being evaluated for lymphoma undergoes a bone marrow biopsy and aspiration to stage the disease and assess for bone marrow involvement., A patient with unexplained anemia and other blood abnormalities has a bone marrow biopsy and aspiration to evaluate for underlying bone marrow disorders.

Documentation should include the reason for the procedure, the site of the biopsy and aspiration, the technique used, and any complications encountered. The pathology report should be included in the patient's record.

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