Pulmonology Coding Alert

Reader Question:

Bronchoscopy

Question: How do I code an extended bronchoscopy with several endobronchial biopsies (bx), brushing (two times), and washings (four times) and needle aspiration performed all at the same time?

Georgia Subscriber

Answer: A bronchoscopy with endobronchial bx, transbronchial needle aspiration biopsy, brushing and washings performed all at the same time should be coded as follows: 31625 (bronchoscopy, [rigid or flexible]; with biopsy); 31629-59 (bronchoscopy, [rigid or flexible]; with transbronchial needle aspiration biopsy) (distinct procedural service), modifier -59 indicates that this biopsy was on a different lesion than the one(s) included in code 31625; and 31623-51 (bronchoscopy, [rigid or flexible]; with brushing or protected brushings) (multiple procedures).

If due to unusual circumstances the procedure required significantly more physician work than would normally be expected, and the documentation clearly reflected this additional work, modifier -22 (unusual procedural services) could be reported [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more