Reporting Endobronchial Ultrasound (EBUS)

Reporting Endobronchial Ultrasound (EBUS)

Endobronchial ultrasound (EBUS) combines a bronchoscope with ultrasound to visualize the bronchi and adjacent structures, and to obtain tissue for biopsy. Sampling by EBUS differs from transbronchial lung biopsy(s) (+31632) or transbronchial needle aspiration biopsy(s) (+31633), neither of which includes an ultrasound component.

Two codes describe EBUS to obtain transtrtacheal and transbronchial sampling:

31652 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures

31653 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures

You may report a single unit of either 31652 or 31653 (but not both), per session, depending on the number of lymph node stations or structures from which tissue is obtained.

Add-on code +31654 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transendoscopic endobronchial ultrasound (EBUS) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion(s) (List separately in addition to code for primary procedure[s]) describes an diagnostic or therapeutic intervention for peripheral lesions. You may report a single unit of 31654, per session, in addition to primary procedures 31622, 31623, 31624, 31625, 31626, 31628, 31629, 31640, 31643, 31645, or 31646.

When reporting 31654 with 31625 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial or endobronchial biopsy(s), single or multiple sites or 31628 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe, you must be certain that the biopsy(s) were not taken with the assistance of EBUS. If the biopsy is taken using EBUS, neither 31625 nor 31628 applies; instead, report the appropriate EBUS biopsy code (e.g., 31654).

For example, a diagnostic bronchoscopy is performed and two suspicious lesions in the mediastinal area of the lung are identified upon performing the diagnostic bronchoscopy. The surgeon takes a single biopsy from each of the two lesions under EBUS. Report 31622, +31652 (because two biopsies were taken from the mediastinal structure).

Barbara Cobuzzi

Barbara Cobuzzi

Barbara J. Cobuzzi, MBA, CPC, CENTC, COC, CPC-P, CPC-I, CPCO, AAPC Fellow, is a consultant with CRN Healthcare Solutions in Tinton Falls, N.J. She is consulting editor for Otolaryngology Coding Alert and has spoken, taught, and consulted widely on coding, reimbursement, compliance, and healthcare-related topics nationally. Barbara also provides litigation support as an expert witness for providers and payers.Cobuzzi is a member of the Monmouth, N.J., AAPC local chapter.
Barbara Cobuzzi

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Barbara J. Cobuzzi, MBA, CPC, CENTC, COC, CPC-P, CPC-I, CPCO, AAPC Fellow, is a consultant with CRN Healthcare Solutions in Tinton Falls, N.J. She is consulting editor for Otolaryngology Coding Alert and has spoken, taught, and consulted widely on coding, reimbursement, compliance, and healthcare-related topics nationally. Barbara also provides litigation support as an expert witness for providers and payers. Cobuzzi is a member of the Monmouth, N.J., AAPC local chapter.

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