Pulmonology Coding Alert

Question: In the article, “Know How to Code Cystic Fibrosis Monitoring and Treatment With This Guide” in Pulmonology Coding Alert, Volume 23, Issue 5, you mentioned autogenic drainage as a method for improving lung function for cystic fibrosis (CF) patients.

Could you further explain autogenic drainage?

Michigan Subscriber

Answer: Autogenic drainage, or self-drainage, is a method of helping move mucus from the patient’s airways. A respiratory therapist teaches the patient how to control their breathing, so they can use different breathing speeds to unstick, collect, and evacuate the mucus from their lungs.

The goal of autogenic drainage is to achieve the highest possible expiratory airflow in the different branches of the airways. By using different lung volumes, the process helps mobilize the secretions from the small peripheral airways (bronchioles) to the larger central airways (bronchi/trachea).

A single cycle consists of three phases, each of which should take about two to three minutes to complete, with the patient completing a cycle of unsticking, collecting, and evacuating the mucus in about six to nine minutes. Patients with CF may need several cycles to clear the sputum from their lungs.

Important: If your pulmonologist demonstrates how to perform autogenic drainage during an evaluation and management (E/M) visit, the education will be included in the E/M visit. Demonstration of autogenic drainage doesn’t qualify for 94667 (Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; initial demonstration and/or evaluation), and “it is not separately reported from an E/M service,” says Carol Pohlig, BSN, RN, CPC, manager of coding and education in the department of medicine at the Hospital of the University of Pennsylvania in Philadelphia.