Pulmonology Coding Alert

Question: A pulmonologist performed a bronchoscopy and then did another one with a new scope. Fibron was injected into the lung to close a bronchopleural fistula. How do I code this?

South Carolina Subscriber

Answer: Code 31622 (bronchoscopy [rigid or flexible]; diagnostic, with or without cell washing [separate procedure]) is always inclusive in a greater procedure performed in the same area. Therefore, regardless if the scope was removed and a new one inserted or whether one scope was used as a diagnostic tool and the other as therapeutic, only the therapeutic one is reportable and is bundled into 31899 (unlisted procedure, trachea, bronchi).

A good rule of thumb is to remember that when separate procedure is listed in the code definition, such as 31622, it signifies that it can be reported only when performed alone.

Regarding the code for injecting fibron into the bronchopleural area to seal off a fistula, currently there is no code that describes this procedure. Therefore, you need to report these services with 31899. You should assign a charge and send in your operative note for review with the claim. To come up with a charge, you should find a procedure that is most similar to what is being performed and adjust it based on whether more or less work was performed.