Wiki 31623 or unlisted

[plarabee]

I am having a debate with another coder regarding the following scenario:

The flexible bronchoscope was passed through the nose. Nasopharynx appeared normal. Larynx and vocal cords appeared abnormal. Trachea appeared normal. Airway anatomy appeared abnormal. Patient had a friable white patchy area appearing like candida infection around the epiglottis and a polyp above the vocal cords. About 80-90 % collapse of the left lower lobe and 30-40% of left main bronchus indicating bronchomalacia. Brush biopsy was done around the white patchy friable area around epiglottis

The path report came back SCC. We are trying to decide which coding would be correct 31623 or an unlisted procedure of the larynx?

Appreciate any feedback you can offer. Thanks.

 

[jessica81680@comcast.net]

The description for 31623 is as follows: "Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with brushing or protected brushings". It appears to apply to your scenario unless the flexible bronchoscope did not include fluoroscopic guidance.

 

[plarabee]

Thanks. That was my choice but she insists because the brushings were not of the lungs or the bronchial airways we had to use an unlisted procedure of the larynx. I appreciate your feedback.

Anyone else?