Pulmonology Coding Alert

Question: A pulmonologist in our practice performed a transbronchial biopsy on a patient. The physician used a flexible bronchoscope to view and capture samples from the left superior and inferior lobes and the right inferior lobe.

Which code should I use to report the procedure?

Michigan Subscriber

Answer: Based on the scenario you’re describing, you’ll assign 31628 (Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe) for the first lobe and two instances of +31632 (… with transbronchial lung biopsy(s), each additional lobe (List separately in addition to code for primary procedure)) for each of the additional lobes. Since the descriptor for 31628 includes the words “single lobe,” you’ll report this code only once, whereas +31632 instructs you to list the code separately for “each additional lobe.”

Assigning 31625 (Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial or endobronchial biopsy(s), single or multiple sites) may be tempting since the descriptor includes “single or multiple sites.” However, you described the procedure as a transbronchial biopsy, which leads you to assign transbronchial biopsy codes 31628 and +31632 x 2 for your claim.