Use 31629 for TBNA via Bronchoscopy
Question: A pulmonologist performed a transbronchial needle aspiration (TBNA) of a right upper lobe (RUL) cavity lesion at the RUL apical. The provider used a 21-gauge needle for cytology. They also used fluoroscopy and cone beam CT imaging guidance. The provider wants to report the bronchoscopy with 31628, but I think 31629 is a more accurate code. What are your thoughts? Pennsylvania Subscriber Answer: While 31628 (Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe) covers a bronchoscopy with fluoroscopic guidance and lung biopsies, the code does not include TBNA. You are correct to use 31629 (… with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i)) for the bronchoscopy with TBNA of the RUL. You should also assign 77012 (Computed tomography guidance for needle placement (eg, biopsy, aspiration, injection, localization device), radiological supervision and interpretation) to report the cone beam CT image guidance. Append modifier 26 (Professional component) to 77012 to report the services of the provider performing the image guidance for the needle placement. Mike Shaughnessy, BA, CPC, Development Editor, AAPC
