Pulmonology Coding Alert

Question: If I start with transbronchial lung biopsy to avoid false positives and then perform transbronchial lung biopsy, can I report both 31628 and 31629 if doing a bronchoscopy?

Wyoming Subscriber
 
 Answer: You can use both 31628 (bronchoscopy; with transbronchial lung bronchoscopy, with or without fluoroscopic guidance) and 31629 (... with transbronchial needle aspiration biopsy). These represent separate procedures, but use modifier -59 (distinct procedural service) instead of modifier -51 (multiple procedures). Multiple surgical bronchoscopy procedures -- such as transbronchial biopsies of the right-upper lobe mass with fluoroscopy and a transbronchial needle aspiration of the subcarinal mediastinal nodes -- can be reported together for one date of service. List the highest-valued procedure first. The remaining procedures are listed according to their value, from highest to lowest. Append modifier -59 to the subsequent procedures as a correct coding principle for identifying multiple procedures. Therefore, the above scenario would be coded 31629, 31628-59. Fluoroscopic guidance is included in bronchoscopy codes 31622-31656 and is not separately reportable.