Pulmonology Coding Alert

Question: Our provider does a TBNA (transbronchial needle aspiration) with a Wang needle from station 1, station 3 and station 7. Would we code this service with only 31629, or would it be appropriate to also use 31633? The provider talks about 11 different stations, and we have some confusion as to whether these are all included in code 31629.


New York Subscriber

Answer: Whether or not you can report 31629 (Bronchoscopy, rigid or flexible, with or without fluoroscopic guidance; with transbronchial needle aspiration biopsy[s], trachea, main stem and/or lobar bronchus[i]) and +31633 (... with transbronchial needle aspiration biopsy[s], each additional lobe [list separately in addition to code for primary procedure]) together depends on the location of the lymph nodes the pulmonologist samples. Lymph nodes in both station 1 and station 3 are located by the trachea, and you should report 31629 for TBNAs in those stations.

Lymph nodes in station 7 are located in the subcarinal region, which is different from the trachea and permits reporting of 31633. 

So on your claim, you should report 31629 for the TBNAs in stations 1 and 3, and 31633 for the TBNAs in station 7.