August 23, 2018

ACR Gains Reversal on Bone Biopsy NCCI Edits

An appeal by the American College of Radiology (ACR) has led the Centers for Medicare & Medicaid Services (CMS) to revise the National Correct Coding Initiative (NCCI) procedure-to-procedure (PTP) edits for bone biopsy procedures.

The PTP edits apply to CPT codes 20220 (Biopsy, bone, trocar, or needle; superficial [eg, ilium, sternum, spinous process, ribs]) and 20225 (Biopsy, bone, trocar, or needle; deep [eg, vertebral body, femur]) reported in conjunction with CPT code 38222 (Diagnostic bone marrow; biopsy[ies] and aspiration[s]).

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