Pulmonology Coding Alert

Question: How would I code for the following scenario? My pulmonologist inserts a bronchoscope and places a 12 x 40 stent in the bronchus. The physician then decides that he doesn't like the position of the stent, so he removes it and places a 12 x 30 stent in the same location.


California Subscriber

Answer: For this scenario, report 31636 (Bronchoscopy, rigid or flexible, with or without fluoroscopic guidance; with placement of bronchial stent[s] [includes tracheal/bronchial dilation as required], initial bronchus). You can only report this code once since it represents any number of stents deployed to the same bronchial region.

If treatment required the pulmonologist to place a stent in a bronchus separate from the initial stent, you could also report +31637 (Bronchoscopy, rigid or flexible, with or without fluoroscopic guidance; each additional major bronchus stented [list separately in addition to code for primary procedure]). Because 31637 is an add-on code, you should use it only in conjunction with a primary code (i.e., 31636).