Pulmonology Coding Alert

Question: I am looking at a claim that shows the pulmonologist performed a laryngoscopy. Notes indicate that the pulmonologist removed a foreign body during the procedure. How should I code this encounter? There are codes for "rigid" and "flexible" laryngoscopies, and I don't know which one to choose.

Minnesota Subscriber

Answer: Basically, you should report 31525 (Laryngoscopy, direct, with or without tracheoscopy; diagnostic, except newborn) when the pulmonologist uses a rigid scope for the procedure. If the pulmonologist uses a flexible scope, opt for 31575 (Laryngoscopy, flexible fiberoptic; diagnostic) instead.

Based on your pulmonologist's actions, she probably used a rigid scope for this particular laryngoscopy.

Explanation: The pulmonologist may use a rigid scope when it is necessary for the procedure (for example, removal of polyps or foreign bodies). She might also use the rigid scope when taking biopsies, performing laser surgery or checking the larynx for cancer.

When the rigid scope is not necessary, the pulmonologist will use a flexible scope because it allows better diagnostic views and tends to be easier on the patient. Check the physician's notes for the encounter. The notes should make it pretty clear which type of laryngoscopy to code for. If the notes are not sufficient help, ask the pulmonologist.