Pulmonology Coding Alert

Question: What code should I report for a bronchoscopy if the pulmonologist was scheduled to "assist" a surgeon while he does a percutaneous tracheostomy? New Mexico Subscriber Answer: You would often encounter a second pulmonologist "assisting" in a percutaneous tracheostomy (31600, Tracheostomy, planned [separate procedure]), which is a planned procedure and commonly performed by pulmonologists, as well as ENT physicians and some thoracic surgeons. The second pulmonologist "assists" by observing the tracheal site during the tracheostomy with a bronchoscope. When coding in this scenario, consider the following: • If the bronchoscopy also includes a medically necessary inspection of all the airways sometime during, before, or after the tracheostomy, then the pulmonologist handling the bronchoscope should bill for a  bronchoscopy (31622, Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed [separate procedure]). This billing should occur if the pulmonologist assists another pulmonologist, ENT physician, a [...]