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Pulmonology Coding Alert

Reader Question:

Distinguish Lavage and Cell Washing by Looking Through Documentation

Published on Wed Aug 22, 2012

Question: Our pulmonologist recently performed a therapeutic aspiration along with lavage on a patient suffering from severe bleeding in the left lower lobe. He also injected epinephrine to bring the bleeding under control. Can you please tell me how I need to code the procedures that our pulmonologist performed?Massachusetts SubscriberAnswer: For the therapeutic aspiration that your pulmonologist performed, you will need to report it with 31645 (Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, initial [e.g., drainage of lung abscess]).To confirm whether or not your pulmonologist performed a bronchial alveolar lavage (BAL) or a cell washing, you will have to look deeper into the documentation. You can identify if your pulmonologist performed a BAL by amount of saline that your pulmonologist used during the procedure. It will usually be about 100cc (with manual suctioning) that is instilled in five fractions of 20cc while [...]
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