Pulmonology Coding Alert

Question: The pulmonologist performed one pre-operative bronchoscopy and another more detailed post-operative bronchoscopy, both with cell washings. How should I report these procedures?

Texas Subscriber

Answer: You should report 31622 (Bronchoscopy, rigid or flexible, with or without fluoroscopic guidance; diagnostic, with or without cell washing) for each procedure the pulmonologist performed before and after surgery. When the physician provides the bronchoscopies on the same day, attach modifier -59 (Distinct procedural service). You need the modifier to get paid for both codes.

And, make sure you justify each procedure by assigning the appropriate ICD-9 codes. For example, if the patient had hemoptysis (786.3) and cough (786.2), you would link 786.3 and 786.2 to 31622 and 31622-59.