Pulmonology Coding Alert

The CPT 2001 manual reveals a few changes in codes that pulmonary billing specialists use every day. Most of the changes reflect expanding technology, such as photodynamic therapy and the use of radiology. Noting these coding changes can mean more prompt payments in 2001.

Photodynamic Therapy Added

Both 96570 and 96571 are new codes, relating to photodynamic therapy:

96570 photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); first 30 minutes (list separately in addition to code for endoscopy or bronchoscopy procedures of lung and esophagus)

96571 for each additional 15 minutes (list separately in addition to code for endoscopy or bronchoscopy procedures of lung and esophagus)

The bronchoscopy code, 31641 (bronchoscopy with destruction of tumor or relief of stenosis by any method other than excision [e.g., laser]), now has a note attached: For bronchoscopic photodynamic therapy, report 31641 in addition to 96570, 96751 as appropriate.

The same note is now attached to 43228 (endoscopy with ablation of tumor[s], polyp[s], or other lesion[s], not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique).

Changes in Radiological Procedures

Some radiological procedures that are associated with pulmonary care have changed. When you need to code a biopsy of the pleura with a percutaneous needle (32400), you will see a note to see 71036, 76360 and 76942, as before, but these codes have changed.

71036 has been deleted. Now you must use 76003 (fluoroscopic guidance for needle placement, e.g., biopsy, aspiration, injection, localization device).

76360 is only slightly reworded; its computerized tomography guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), radiological supervision and interpretation. Code 73635 (computerized tomography guidance for cyst aspiration, radiological supervision and interpretation) has been deleted.

76942 is also slightly reworded to include new technology ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation.

Under 32400 (biopsy, pleura; percutaneous needle), theres a note to see 88170-88173 for fine needle aspiration, preparation and interpretation of smears. The note differentiates between fine needle aspiration (used, for example, to examine a lung mass on x-ray), and other types of needle biopsy.

88170 fine needle aspiration; superficial tissue (e.g., thyroid, breast, prostate)

88171 fine needle aspiration; deep tissue under radiologic guidance

88172 cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy of specimen(s)