Pulmonology Coding Alert

Question: The pulmonologist sees a patient with acute respiratory failure, and decides to perform a biopsy to diagnose the problem. He performs a transbronchial lung biopsy with the help of fluoroscopic guidance to navigate the forceps to the upper lobe of the lung. How should I report this?

Wyoming Subscriber

Answer: You would code 31628 (Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy[s], single lobe) for bronchoscopy with transbronchial biopsy.

Remember: Surgical bronchoscopy like 31628 always includes diagnostic bronchoscopy when performed by the same physician.

If the physician performs an additional biopsy from another lobe in either lung, you would use +31632 (...with transbronchial lung biopsy[s], each additional lobe [List separately in addition to code for primary procedure]) to report it. When coding 31632, you can only report each code once per lobe, regardless of how many transbronchial lung biopsies or needle aspirations the physician performs in that lobe.