Outpatient Facility Coding Alert

Question: How do we bill with the new code 31652?

Texas Subscriber

Answer: CPT^® 2016 introduced three new codes for reporting various nuances of endobronchial ultrasound (EBUS) during bronchoscopy.

Before 2016: Prior to this year, you could only report EBUS through a single code: +31620 (Endobronchial ultrasound [EBUS] during bronchoscopic diagnostic or therapeutic intervention[s] [List separately in addition to code for primary procedure(s)]) that is added to the primary procedure (for example, 31629, Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy[s], trachea, main stem and/or lobar bronchus[i]), which represents the sampling.

As of Jan. 1, 2016: CPT^® added a dedicated new code 31652 (Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound [EBUS] guided transtracheal and/or transbronchial sampling [e.g., aspiration{s}/biopsy{ies}], one or two mediastinal and/or hilar lymph node stations or structures) for EBUS aided biopsy/aspiration. You report this single code if the physician limits her view to one or two lymph node structures.

Expanding on code 31652, you have two more codes:

• 31653 (… 3 or more mediastinal and/or hilar lymph node stations or structures) for provision of examination of three or more lymph node structures and
• 31654 (Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transendoscopic endobronchial ultrasound [EBUS] during bronchoscopic diagnostic or therapeutic intervention[s] for peripheral lesion[s] [List separately in addition to code for primary procedure(s)]) for examination of peripheral lesions during EBUS.

Reminder: The pulmonologist usually performs an EBUS when she discovers a vascular abnormality during a diagnostic bronchoscopy. The physician may also take biopsies or aspirations (transbronchial needle aspiration [TBNA]) with EBUS support.

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