Pulmonology Coding Alert
Primary Procedure Code Precedes 31627
Question: Our pulmonologist saw a patient with breathing difficulties and blood in the cough. Suspecting possible lung cancer, our pulmonologist used electromagnetic navigation bronchoscopy (ENB) and a needle biopsy to help diagnose the lung cancer. What code should I submit for the test? What is an ENB?
Maryland Subscriber
Answer: For the primary procedure, you should submit code 31628 (Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy[s], single lobe) or 31629 (Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy[s], trachea, main stem or lobar bronchus[i]), depending on if any nodes were sampled via needle aspiration biopsy. For ENB reimbursements, you may submit a CPT® code +31627 (Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with computer-assisted, image-guided navigation [List separately in addition to code for primary procedure(s)]). While the code allows physicians to be reimbursed for performing ENB, make sure you list +31627 separately in addition to a primary bronchoscopy code since 31627 is a add-on code, which requires the listing of another primary bronchoscopy code when used. These codes are related to another service and are always included in the global period of the primary service.
What goes on: ENB is a two-step process. Initially the pulmonologist synchronizes the patient’s chest CT with a specialized computer program to allow for a virtual bronchoscopy. The pathway to the lung lesion is mapped onto the program. The pulmonologist usually does it well before the bronchoscopy procedure. During the bronchoscopy, the patient lies on a table which allows for an electromagnetic field to be established. The bronchoscopy happens by utilizing the previously mapped computer image to guide the bronchoscope to the site of the lesion. Then, the pulmonologist inserts a special navigational catheter into the bronchoscope and maneuvers into the lesion or near the lesion. He then inserts a transbronchoscopic needle into the lesion to biopsy the lesion. You would code 31628 for the biopsy and 31627 for the ENB.
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Primary Procedure Code Precedes 31627
Question: Our pulmonologist saw a patient with breathing difficulties and blood in the cough. Suspecting [...]
