Otolaryngology Coding Alert

Count nasal/larynx scope as part of bronchoscopy, NCCI states

You'll submit flawless bronchoscopy claims without violating a dozen new bundling edits if you code only the most extensive scope.

The National Correct Coding Initiative, version 11.2, makes nine ENT codes components of new bronchoscopy codes 31636 and 31638. That means, even if an otolaryngologist performs endoscopy, laryngoscopy or nasopharyngoscopy before bronchoscopy with stent placement or revision, you should report only the most extensive scope - the bronchoscopy.

As of July 1, 31636 (Bronchoscopy, rigid or flexible, with or without fluoroscopic guidance; with placement of bronchial stent[s] [includes tracheal/bronchial dilation as required], initial bronchus) and 31638 (... with revision of tracheal or bronchial stents inserted at previous session [includes tracheal/bronchial dilation as required]) include these ENT procedures:
  31231 - Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure)
  31525 - Laryngoscopy, direct, with or without tracheoscopy; diagnostic, except newborn
  31526 - ... diagnostic, with operating microscope
  31535 - Laryngoscopy, direct, operative, with biopsy
  31536 - ... with operating microscope
31540 - Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis
  31541 - ... with operating microscope
31575 - Laryngoscopy, flexible fiberoptic; diagnostic
92511 - Nasopharyngoscopy with endoscope (separate procedure). NCCI permits a modifier when appropriate to override only one of these edits - the nasal diagnostic endosocopy with bronchoscopy. You may use a modifier to unbundle 31231 from 31636 or 31638 when circumstances warrant dual reporting.