Pulmonology Coding Alert

Question: The pulmonologist at our practice recently performed a bronchoscopy and placed more than one stent in each lung. Should I bill for only one stent or the number he put in?

Texas Subscriber

Answer: You should report stent placement only once per session. You may also consider appending modifier -22 (Unusual procedural services) to the procedure code to indicate that the procedure was "greater than usual." Explicit documentation of the procedure (e.g., how much extra time, effort, etc., was involved) is required when reporting modifier -22. You should manually send a copy of the report with the claim. Acover letter is also suggested indicating the use of modifier -22 and the requested additional reimbursement desired. The insurer will decide if any additional reimbursement is warranted after reviewing the documentation.