Pulmonology Coding Alert

Question: Our pulmonologist recently performed a stent placement into the bronchus. During the procedure, our pulmonologist inserted a bronchoscope and placed a 12 x 40 stent initially. But since he was not satisfied about the stent's positioning, he decided to remove the stent and replaced it with a 12 x 30 stent into the same location. How do I report this procedure? Should I report the placement of both the stents?

New York Subscriber

Answer: You should report the procedure performed by your pulmonologist using 31636 (Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of bronchial stent[s] [includes tracheal/bronchial dilation as required], initial bronchus). If you see the descriptor for the code, you will notice that the same code applies even if your pulmonologist placed one or more stents in the same location in the bronchus. So, in this scenario, you will only have to use 31636 to report the procedure although your pulmonologist used two stents during the procedure.

If your pulmonologist placed one stent in one bronchus area and another stent in a totally separate bronchus, then you have to report 31636 and the add-on code +31637 (Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; each additional major bronchus stented [List separately in addition to code for primary procedure]). Note that you will have to report stent(s) placed in each major bronchus with the add-on code +31637. For example, if your pulmonologist placed one stent in the RUL (right upper lobe), and two more stents in the LUL (left upper lobe), then you will report the procedure using 31636 and 1 unit of +31637.

Remember that 31637 is an add-on code for additional stents placed in each major bronchi and you cannot report these stent placement procedures without listing the primary stent placement procedure in one area of the bronchus with 31636.