How To Use CPT Code 20220

CPT code 20220 describes a superficial bone biopsy procedure that involves obtaining a sample of bone tissue for further analysis. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 20220?

CPT 20220 is used to describe a superficial bone biopsy procedure. This procedure involves the provider obtaining a sample of bone tissue from a specific area of the body for further analysis. The biopsy is performed using a large diameter biopsy needle or bone trocar, which is inserted through a small incision in the skin. The provider then debrides the tissue and collects the bone sample for laboratory examination.

2. Official Description

The official description of CPT code 20220 is: ‘Biopsy, bone, trocar, or needle superficial (eg, ilium, sternum, spinous process, ribs).’

3. Procedure

The superficial bone biopsy procedure involves the following steps:

1. The patient is appropriately prepped and anesthetized.
2. The provider examines the area to be biopsied.
3. A small incision is made over the targeted area using a scalpel.
4. A large diameter biopsy needle or bone trocar is advanced through the incision and directed towards the bone.
5. The provider debrides the tissue and collects the bone sample in the needle or trocar.
6. The bone sample is preserved and processed for further laboratory examination.
7. The provider closes the incision.

4. Qualifying circumstances

CPT 20220 is typically performed when there is a suspected medical condition or infection that requires further analysis of bone tissue. The procedure is performed by a qualified healthcare professional who is trained in performing bone biopsies. The specific areas of the body where the biopsy is performed include the ilium, sternum, spinous process, and ribs.

5. When to use CPT code 20220

CPT code 20220 should be used when a superficial bone biopsy procedure is performed using a trocar or needle. It is important to note that this code is specifically for superficial bone biopsies and should not be used for deep bone biopsies or bone marrow biopsies. If a bone marrow specimen is obtained for diagnostic purposes, different codes should be used.

6. Documentation requirements

To support a claim for CPT 20220, the healthcare professional must document the following information:

• Patient’s medical condition or suspected infection that necessitates the bone biopsy
• Specific area of the body where the biopsy is performed (eg, ilium, sternum, spinous process, ribs)
• Date of the procedure
• Details of the procedure, including the use of a trocar or needle
• Description of the collected bone sample
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT 20220, ensure that the procedure meets the criteria for a superficial bone biopsy using a trocar or needle. It is important to accurately document the procedure and provide the necessary supporting documentation. Additionally, be aware of the specific coding guidelines for bone biopsies and differentiate between bone biopsies and bone marrow biopsies.

8. Historical information

CPT code 20220 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT 20220

There are several similar codes to CPT 20220 that describe different types of bone biopsies. These include:

• CPT 20225: Deep bone biopsy of a vertebral body or the femur
• CPT 38221: Bone marrow biopsy (diagnostic)
• CPT 38220: Bone marrow aspiration (diagnostic)

9. Examples

1. A provider performing a superficial bone biopsy on the ilium to investigate a suspected bone infection.
2. A healthcare professional conducting a superficial bone biopsy on the sternum to further analyze a patient’s bone tumor.
3. A surgeon performing a superficial bone biopsy on a spinous process to evaluate a patient’s spinal condition.
4. A specialist performing a superficial bone biopsy on the ribs to investigate a suspected fracture or bone disease.
5. A healthcare professional conducting a superficial bone biopsy on the ilium to analyze bone tissue for signs of osteoporosis.
6. A provider performing a superficial bone biopsy on the sternum to investigate a suspected bone marrow disorder.
7. A surgeon conducting a superficial bone biopsy on a spinous process to evaluate a patient’s bone infection.
8. A specialist performing a superficial bone biopsy on the ribs to investigate a suspected bone metastasis.
9. A healthcare professional conducting a superficial bone biopsy on the ilium to analyze bone tissue for signs of bone cancer.
10. A provider performing a superficial bone biopsy on the sternum to investigate a suspected bone fracture.