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Pulmonology Coding Alert

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Bronchoscopy Through Established Tracheostomy Leaves Questions

Published on Tue Apr 28, 2009

Question: How do you code a bronchoscopy that is done through an established tracheostomy? Frequently our physicians will perform a therapeutic bronchoscopy (31645), but instead of using a nasal approach, they enter through the established tracheostomy endotracheal tube. There has been discussion on how we should code this. Using 31615 doesnt seem appropriate because it doesnt include any of the work that is performed during therapeutic or other bronchoscopies. Because the approach is different, should I use 31899 supported with operative notes? Or would it be more appropriate to use 31645? Virginia Subscriber Answer: This is a good question with no clear correct answer, but there are several options that you can weigh. You are right that it is incorrect to use 31615 (Tracheobronchoscopy through established tracheostomy incision) for this procedure. Code 31615 is just a look through the tracheostomy and doesnt include any other maneuvers. Many practices may choose [...]
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