# DL with Rigid Bronchoscopy



## cworsley (Jan 21, 2016)

Two questions:

When a physician states pre/postoperative diagnosis of "Failure to extubate", all the literature I read states the physician should indicate the reason for the failure and that should be the diagnosis.  What are your thoughts?

I have a practice that completes DL and Rigid Bronchoscopy, in the OP note they never state the Laryngoscope removed and the insertion of the bronchoscope.  The OP notes states A direct laryngoscopy was done using a Parsons slotted laryngoscope.  The supraglottis appeared to be normal.  The vocal cords were sprayed using 4% lidocaine on LTA.  A 2.7mm telescope was then used to visualize the cords, the glottic edemawas seen secondary to intubation, and the subglottis appreared to be normal.  The scope was then advanced all the way to the carina.  The righ and left maistream bronchus was normal.  The scope was withdrawn.

In my experience we would only code the Bronchoscopy.........I was advised if they stated the Laryngoscope was removed and then Bronchoscope was entered we could bill for both, otherwise for the scope in which the physician stops (Bronchus).  

I am curious for thoughts and experience in this area.

Thank you


----------



## catprocode (Apr 11, 2016)

*I agree!*

Our doctor's always state they remove the laryngoscope then insert the bronch if they don't say that then only bill for bronch. When I code these I always add a mod 59 on the 31526 along with a separate diagnosis to show it was done for a different reason.


----------

