Pulmonology Coding Alert

While not part of the CCI 15.2 edits, you should be alert to a hidden coding opportunity if your pulmonologist performs bronchial biopsies. In previous edits, CCI has bundled 31625 (Bronchoscopy, rigid or flexible, with or without fluoroscopic guidance; diagnostic, with or without cell washing [separate procedure], with bronchial or endobronchial biopsy[s], single or multiple sites) in with 31628 (Bronchoscopy, rigid or flexible, ... with transbronchial lung biopsy[s], single lobe) and 31629 (... with transbronchial needle aspiration biopsy[s], trachea, main stem and/or lobar bronchus[i]), explains Alan L. Plummer, MD, professor of medicine in the division of pulmonary, allergy, and critical care at Emory University School of Medicine in Atlanta.

Unbundle 31625 from 31628 or 31629 with modifier 59 (Distinct procedural service) on 31625 when your pulmonologist performs and documents these separate techniques since the target tissue will be different, advises Plummer, until CCI deletes these unnecessary pairs.