Pulmonology Coding Alert

Question: A patient presents with acute respiratory failure. The pulmonologist must obtain biopsies from the patient's lungs to diagnose the problem.

Because the patient is having respiratory failure, the pulmonologist performs an open lung biopsy. Therefore, the pulmonologist performs a transbronchial lung biopsy with the help of fluoroscopic guidance to navigate the forceps to the upper lobe of the lung.

How should I report this to get full reimbursement? 


South Carolina Subscriber


Answer: You code the bronchoscopy with transbronchial biopsy as 31628 (Bronchoscopy, rigid or flexible ...; with transbronchial lung biopsy[s], single lobe).

If the physician must also take a biopsy from another lobe in either lung, you report this as +31632 (...with transbronchial lung biopsy[s], each additional lobe [list separately in addition to code for primary procedure]) to indicate an additional biopsy taken from a different lobe.

Keep in mind that for both 31632 and +31633 (...with transbronchial needle aspiration biopsy[s], each additional lobe [list separately in addition to code for primary procedure]), you can only report each code once per lobe, regardless of how many transbronchial lung biopsies or needle aspirations the physician performs in that lobe, CPT states.