Pulmonology Coding Alert
Modifier -51
Louisiana Subscriber
Answer: You cant bill 31622 (bronchoscopy, [rigid or flexible]; diagnostic, with or without cell washing [separate procedure]) with any of the other codes youve listed, because as a separate procedure it is considered a component of all of the other services in question. Theres no problem with billing any of the other codes in combination. Use of any of these codes does not require a modifier for Medicare. Payment is figured using the multiple endoscopy rule (highest valued procedure will be paid at 100 percent, subsequent procedures paid at the difference between the allowable for that procedure and the allowable for that procedure and the allowable for the base endscopy [31622]). Some commercial insurance companies may request modifier -51 on all but the highest valued procedure, and they may pay under a different formula from Medicare. You should contact commercial carriers in advance to determine their payment menchanism for multiple endoscopies.
Pulmonology Coding Alert
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