Pulmonology Coding Alert
Don't Report Same Lobe Biopsies With +31632
Question: Our pulmonologist recently performed a bronchoscopy on a patient. During the procedure, he found three lesions in the anterior and lateral segments of the lower left lobe. He performed transbronchial biopsies of both the lesions and sent them to the lab for analysis. I want to report 31628, 31632 and 31632-59 for the procedure that our pulmonologist performed. Is this appropriate?
Answer:When your pulmonologist performs a transbronchial biopsy in one lobe, you will have to report the procedure with 31628 (Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy[s], single lobe). If you look at the descriptor, this CPT® code should be used for all the transbronchial biopsies that your pulmonologist performed in one lobe.
If the biopsy or biopsies were then performed in a third lobe, you will have to report more than one unit of +31632. For example, if your pulmonologist performed the initial transbronchial biopsy in the left upper lobe and then performed another biopsy in the left lower lobe and then proceeded to perform additional biopsies in the right lower lobe, you will have to report 31628 and two units of +31632.
In your case scenario, since your pulmonologist performed all the biopsies in the same lobe, i.e. the left lower lobe, you will only report one unit of 31628 to report the procedure and not report +31632.
Note: When reporting additional units of +31632, you will only need to report it as +31632 x the number of additional units rather than use the modifier 59 (Distinct procedural service)to distinguish the repeat of the procedure in the additional lobes, unless a payer suggests otherwise.
Michigan Subscriber
If your pulmonologist performed transbronchial biopsy in two or more lobes, then you will have to report the procedures with 31628 for the initial biopsy in one lobe and report the biopsy or biopsies in the additional lobe with +31632 (Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy[s], each additional lobe [List separately in addition to code for primary procedure]).
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