Pulmonology Coding Alert
Reporting Subsequent Therapeutic Bronchoscopies
Oregon Subscriber
Answer: You should use 31646 (Bronchoscopy [rigid or flexible]; with therapeutic aspiration of tracheobronchial tree, subsequent) to report the second therapeutic bronchoscopy that your pulmonologist performs on the same day that he performed another therapeutic bronchoscopy earlier.
If a patient requires subsequent therapeutic bronchoscopies during the same hospitalization, you should use 31646 to report those as well. To code the initial therapeutic bronchoscopy, use 31645 (Bronchoscopy [rigid or flexible]; with therapeutic aspiration of tracheobronchial tree, initial [e.g., drainage of lung abscess]).
Codes 31645 and 31646 have zero-day global periods, meaning you should only report them once per day. This might lead you to believe that you can report 31645 many times throughout a single hospitalization, but insurer rules may contradict this.
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