Pulmonology Coding Alert

Question: I know that the National Correct Coding Initiative allows us to bill 31624 with 31615, as long as we append a modifier, but what would be a real-life instance in which we could bill these two procedures together? 

If the pulmonologist completes a tracheostomy while completing a bronchial lavage, would billing 31615 along with 31624 constitute over-billing? Should we report the tracheostomy approach (31615) as a separate procedure, followed by the lavage (31624) with modifier -59?


Maryland Subscriber

Answer: In general, if the patient with a tracheostomy requires bronchoscopy with bronchial lavage, you should report 31624 (Bronchoscopy [rigid or flexible]; ... with bronchial alveolar lavage). 

You should not report 31615 (Tracheobronchoscopy through established tracheostomy incision) because NCCI considers 31624 a component a 31615. 

However, if the patient with a tracheostomy required a second bronchoscopy for that day, and the pulmonologist did not perform any other procedure other than the bronchoscopy, you can charge 31615, using modifier -59 (Distinct procedural service).

Answers for You be the Coder and Reader Questions were reviewed by Carol Pohlig, BSN, RN, CPC, senior coding and education specialist at the University of Pennsylvania department of medicine in Philadelphia; and Alan L. Plummer, MD, professor of medicine, Division of Pulmonary, Allergy and Critical Care at Emory University School of Medicine in Atlanta.