Wiki Bronchoscopy after surgery

[dpumford]

Hello: Pt had a Rt Middle Lobectomy done 32480. Surgeons also would like to bill for the brochoscopy 31622- I know I can use mod 59 but what I am questioning is if the documenation is supportive of the bronchoscopy??

A therapeutic bronchoscopy was performed after the procedure was completed. A single-lumen bronchoscopy was performed after the procedure was completed. A single-lumen tube was passed and thorough cleansing of the traceobronchial tree was carried out.

This is all that was dicated which was last paragraph of reports.

Any suggestions

Tx's

 

[Lujanwj]

I'd be less concerned about the documentation and turn my focus to Medical Necessity and can I justify 'Separate and Distinct" -59. If you can show that one had nothing to do with the other and medical necessity for it, bill it with -59.


NCCI Policy Manual Chapter 5 C.7 - Yes, this is Urinary but concepts still apply.

7. If a diagnostic endoscopy leads to the performance of a laparoscopic or open procedure, the diagnostic endoscopy may be separately reportable. Modifier 58 may be reported to indicate that the diagnostic endoscopy and non-endoscopic therapeutic procedures were staged or planned procedures. The medical record must indicate the medical necessity for the diagnostic endoscopy. However, if an endoscopic procedure is performed as an integral part of an open procedure, only the open procedure is reportable. If the endoscopy is confirmatory or is performed to assess the surgical field ("scout endoscopy"), the endoscopy does not represent a separate diagnostic or surgical endoscopy. The endoscopy represents exploration of the surgical field, and should not be reported separately with a diagnostic or surgical endoscopy code.