Pulmonology Coding Alert

Question:Can you, at any time during an outpatient bronchoscopy, bill an E/M outside of a separate diagnosis, complication, or decision for a procedure? (For instance, reporting 99213 with 31628 and 99213 represents counseling, medication reconciliation, family issues, and future plans.)Washington, D.C. SubscriberAnswer:You can only bill a separate E/M on the same day as a procedure when a separately identifiable issue is managed. Counseling the patient's family issues does not constitute medical management, neither does reviewing the post-procedural care instructions.Also, keep in mind that a cursory history and physical (i.e., brief history including medication reconciliation and brief exam) is a must on procedure day to collect the necessary pre-procedural information and confirm the patient's ability to undergo the procedure. Management of a separate issue requires additional work beyond the scope of the procedure (e.g., review of management options for IDL-interstitial lung disease -- newly confirmed through bronchoscopy).CPT says: "You can bill a [...]