Helen Treon asked:
The maxillofacial surgery clinic where I was just hired has been using 38220 BMA and 20900 Bone Graft in order to bill for the harvesting and injection of platelet poor plasma; calcium; and thrombin into a malunion of a mandible fracture. Would it be more appropriate to bill 38230 Bone Marrow Harvest for transplantation? If so; would I still use 20900 Bone Graft?
Answer:
According to the NCCI; an edit exists with 20900.
38220 is a Column 2 code. If both 20900 and 38220 are submitted; "only 20900 will be paid"
- This edit CANNOT be overridden via CCI-associated modifiers.
Code 38230 is from the body a donor.
Code 38220 obtains bone marrow for diagnostic purposes only. It does not involve obtaining a sufficient amount of bone marrow for transplant purposes and a provider would not separately report the code if a provider performs this service at the same time as harvesting bone marrow for transplantation.
Look at code 38232. In this procedure; the provider aspirates bone marrow tissue with the help of a needle; to place it back into the bone marrow cavity of the same patient; typically at a later date- but it does not have to be at a later date.
The maxillofacial surgery clinic where I was just hired has been using 38220 BMA and 20900 Bone Graft in order to bill for the harvesting and injection of platelet poor plasma; calcium; and thrombin into a malunion of a mandible fracture. Would it be more appropriate to bill 38230 Bone Marrow Harvest for transplantation? If so; would I still use 20900 Bone Graft?
Answer:
According to the NCCI; an edit exists with 20900.
38220 is a Column 2 code. If both 20900 and 38220 are submitted; "only 20900 will be paid"
- This edit CANNOT be overridden via CCI-associated modifiers.
Code 38230 is from the body a donor.
Code 38220 obtains bone marrow for diagnostic purposes only. It does not involve obtaining a sufficient amount of bone marrow for transplant purposes and a provider would not separately report the code if a provider performs this service at the same time as harvesting bone marrow for transplantation.
Look at code 38232. In this procedure; the provider aspirates bone marrow tissue with the help of a needle; to place it back into the bone marrow cavity of the same patient; typically at a later date- but it does not have to be at a later date.
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