# Argon Plasma Coagulation - Pulmonary Coding Please Help



## jschultz3 (Jan 11, 2018)

Hello

I need help with coding the below as I am new to Pulmonary and want to make sure I am doing this correctly so any help would be tremendously appreciated. .  I am not sure about the coding of the APC.   I am getting codes 31653,31623, 31647, 31641, 31631.     Thank you!!

The scope was passed with ease via the ET. Direct visualization of the lymph nodes was obtained using endobronchial ultrasound (EBUS) guidance. A complete ultrasound lymph node exam was performed for lymph node stations 2, 4, 7, 10 and 11.  The following lymph nodes were subjected to EBUS guided biopsy using standard technique and in the following order:
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1.  Station 7  (approximately 2.1cm in short axis)
2.  L-10 (approximately 1.5cm in short axis)
3.  L-4 (approximately 2.0cm in short axis)
4. R-4 ( approximately 2.5 cm in short axis) 
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 A standard bronchoscope was used to perform a complete airway inspection. 
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Right Main Stem Bronchus 2x1cm endobronchial tumor was noted in the right mainstem with irregular surrounding mucosa, there was partial collapse of the lumen by 50%. Specimen taken: cytology brushing of the irregular mucosa and endobronchial biopsy of the tumor was completed. APC was to apply to the tumor and subsequent successful debulking was completed. A CRE dilation balloon was inflated to 12mm in the airway with subsequent 3x12mm partial covered ultraflex boston scientific stent was successfully deployed with fluoroscopy. Photos taken and scanned into the chart. 
Right Upper Lobe Bronchi Normal mucosa
Right Middle Lobe Bronchi  Edematous mucosa
Right Lower Lobe Bronchi (including the Superior segment)  Normal mucosa
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Specimens Taken
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1.  Washings were obtained from throughout the airways.
2.  Brushings were obtained in the region right mainstem
3. Endobronchial Biopsies - Number of Biopsies -  1  Location(s) - right mainstem bronchus
5 FNA biopsy of the above mentioned stations.


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