Pulmonology Coding Alert

Question: I have a report that states the physician used a bronchoscope to evaluate the patient’s tracheobronchial tree. The report also mentions that the physician captured sterile saline washings and the washings were sent for examination.

What codes do I need to report for this encounter?

Colorado Subscriber

Answer: You need to assign only 31622 (Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)) for this report.

When you examine the descriptor, you’ll notice the phrase “when performed” when referencing the cell washings. That phrase means the code includes the cell washings when that procedure occurs during the same encounter as the diagnostic bronchoscopy.

Additionally, if your provider’s documentation also mentions fluoroscopic guidance, the guidance is included with 31622, when performed, according to the descriptor and the Endoscopy guidelines before the codes in the Trachea and Bronchi section of the Respiratory CPT^® chapter.