Pulmonology Coding Alert

Before you report the bilateral modifiers on your claim, make sure you know whether your chest care services can be reported bilaterally. You can confirm which services are modifier 50-eligible by consulting the Medicare Physician Fee Schedule. Following you can find a sampling of commonly-billed pulmonology codes and which categories they fall into:

Bilateral Surgery Rules Don’t Apply (Have a “0” in the Fee Schedule):

• 31624 -- Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage
• 31530 -- Laryngoscopy, direct, operative, with foreign body removal
• 31513 -- Laryngoscopy, indirect; with vocal cord injection
• 32607-32609 -- Thoracoscopy

Inherently Unilateral – You Can Append Modifier 50 (Have a “1” in the Fee Schedule):

• 31572 -- Laryngoscopy, flexible; with ablation or destruction of lesion(s) with laser, unilateral 
• 32036 -- Thoracostomy; with open flap drainage for empyema 
• 32555 -- Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance
• 31545-31546 – Laryngoscopy

Inherently Bilateral – Do Not Report Modifier 50 (Have a “2” in the Fee Schedule):

• 32853-32854 -- Lung transplant