Radiology Coding Alert

Question: Our radiologist interpreted an unenhanced prepro­cedural CT of the chest for a patient about to undergo a navigated diagnostic bronchoscopy. Are there any special rules for coding the preprocedural imaging?

Wyoming Subscriber

Answer: The varying CT protocols utilized will not affect the code selection. Instead, you’ll code this as a traditional CT chest without contrast after confirming in the technique that the provider did not administer contrast. You may report code 71250 (Computed tomography, thorax; without contrast material) for this service. If the same interventional radiologist interprets the CT and subsequently performs the navigated bronchoscopy, you may report both codes.

A navigated diagnostic bronchoscopy will involve fluoroscopic guidance and may be reported separately using code 31622 (Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)) when performed on the same date of service (DOS) as 71250. In fact, National Correct Coding Initiative (NCCI) edits allow for 71250 to be billed with any navigated bronchoscopy listed within code range 31622-31661 without the need for an overriding modifier.