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Tag Archives: Biopsy

Needle biopsy of the thymus

Please help me code this procedure. The physician states that under generous local anesthesia using CT guidance a 19 gauge trocar needle was advanced into the thymus gland. Multiple small fragmented core specimens were obtained with an E gauge spring biopsy needle. Both needles removed. Post biopsy scanning show no acute hematoma or pneumothorax. Small pneumomediastinum presumbably air introduced from the external environment. Pt. tolerated procedure well without immediate complication. impression: Successful CT guided biopsy of thymus gland. No immediate complications. Small window for needle biopsy. Small fragmented core specimens obtained. Was not overly aggressive at obtaining larger core biopsy smaples as the thymus appears more normal in size and shape on today’s study – less prominent than previously. I cannot find anywhere a code for needle biopsy of the thymus. Closest thing is biopsy medinastinum, 32405, but that needs a modifier (50, LT, RT). I am at complete loss does anyone know how this should be coded and if you have any material supporting the suggested code, that would be very much appreciated also. Thanks!

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Reimbursement for Bone Marrow Aspiration and Biopsy


When bone marrow aspiration is performed alone, the appropriate code to report is CPT code 38220. When a bone marrow biopsy is performed, the appropriate code is CPT code 38221 (bone marrow biopsy). This code cannot be reported with CPT code 20220 (bone biopsy). CPT codes 38220 and 38221 may only be reported together if the two procedures are performed at separate sites or at separate patient encounters.

Separate sites include bone marrow aspiration and biopsy in different bones or two separate skin incisions over the same bone. When both a bone marrow biopsy (CPT code 38221) and bone marrow aspiration (CPT code 38220) are performed at the same site through the same skin incision, do not report the bone marrow aspiration, CPT code 38220, in addition to the bone marrow biopsy (CPT code 38221).

HCPCS/CPT code G0364 may be reported to describe the bone marrow aspiration performed with bone marrow biopsy through the same skin incision on the same date of service.


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