Pulmonology Coding Alert

CPT Assistant's recommendation is a better option than 77299.

Instead of letting conflicting advice on coding the treatment planning stage of electromagnetic bronchoscopy (ENB) bog you down, follow the AMA's simple solution.

CPT Assistant advises you to report 76499 (Unlisted diagnostic radiographic procedure), not 77299 (Unlisted procedure, therapeutic radiology clinical treatment planning). The system manufacturer recommended the latter code at one point.

"CPT Assistant language is considered the bible of clarifying CPT coding," William T. Thorwarth Jr., MD, AMA CPT editorial panel chair, reminded attendees at the CPT and RBRVS 2009 Annual Symposium in Chicago.

Reporting 77299 isn't appropriate for ENB planning because it's a radiation therapy planning code, says Sandra Reed, MBA, director of reimbursement for SuperDimension in Minneapolis, Minn. "We've been suggesting 76499 for many years,"

she adds. The AMA further explains the reason for 76499, stating, "The appropriate bronchoscopy code would be reported for the surgical intervention performed subsequent to the preplanning by the use of navigational software," according to CPT Assistant March 2008.

ENB consists of three phases that you code separately: planning, treatment, and navigation. Once you select 76499 for planning (step 1), you still code the procedure and navigation portions. Here's how:

Step 2: Select the appropriate procedure code for the biopsies, brushings, or needle aspirations (31622-31633, 31641, or 31643).

Step 3: Complete your claim with 31899 (Unlisted procedure of the bronchi or trachea) for navigation.