Pulmonology Coding Alert

Question:Op note says: The pulmonologist introduced the scope through the right nostril and advanced to the vocal cords and into the trachea. The tracheal rings appeared normal. The physician, then, withdrew the scope to the upper lobe and lower lobe subsegments. No endobronchial lesions were noted. The scope was withdrawn and advanced to the right upper lobe and right middle and lower lobe subsegments. No endobronchial lesions noted. Then, under fluoroscopic guidance, the scope was wedged in the right upper lobe and posterior subsegment, and the area corresponding to the lung nodule was noted on fluoroscopy, and transbronchial biopsy was performed four times under fluoro guidance. Again, under fluoro guidance, the physician performed cytology brushing twice, and bronchoalveolar lavage (BAL) on the same area (sent for path and cyto and culture and sensitivity). We billed 31623, 31624 and 31628, 31632x3 but the payer denied 31632x3. What did we do wrong? [...]