Inpatient Facility Coding & Compliance Alert
Bronchoscopy Coding Blues: 31622 or 31624?
Question: The provider’s documentation reads: “Diagnostic bronchoscopy procedure: noted copious amounts of mucopurulent brownish material in airways, removed samples with suction and lavage and sent to lab for routine studies.” Should I report 31622 or 31624?
Texas Subscriber
Answer: Because the procedure described is a diagnostic bronchoscopy and the surgeon uses the lavage to remove material for further study, the best code choice is 31622 (Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed [separate procedure]). This represents a simple cell washing that is often done as part of a diagnostic bronchoscopy. The cell washing might be used with a biopsy and bronchial brushing to evaluate for malignancy, for instance.
Similar code 31624 (Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage) also refers to the bronchoalveolar lavage (BAL), but the procedure typically involves instillation of larger quantities of saline. The BAL is often done for treatment to remove mucous plugs in patients with unexplained infiltrates.
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