Ask Dr. Z

Can you please help me understand this report. The patient has erythrocytosis. The "order" was for "BMBX" (all done same needle path/location). My doctor goes back and forth with his terminology, and it's confusing me. He says at the beginning of report he is doing a "CT-guided bone marrow aspiration of right posterior iliac crest and a CT-guided core needle biopsy of the right posterior iliac crest". In the body of the report, he says, ".20 mL of bone marrow aspirate was obtained and sent to lab for analysis. In order to obtain adequate bone marrow sample, a core biopsy was required. Next a single core bone biopsy sample was collected in formalin using the 11 gauge introducer needle. Impression: Successful CT-guided bone marrow aspiration. Successful CT-guided bone marrow core." I want to bill codes 38221, G0364, and 77012-26 because he keeps going back and forth with "core bone" and "bone marrow core", but I'm not sure.