Pulmonology Coding Alert

Question: I know that you need to use the unlisted CPT® code 31899 to describe bronchial thermoplasty, but I want to know what CPT® you should benchmark this to. Has anyone ever had any luck getting reimbursement? If so, what are some tips to get bronchial thermoplasty paid as it is experimental?

Vermont Subscriber

Answer: Bronchial thermoplasty is a bronchoscopic procedure that employs radiofrequency ablation to reduce the mass of airway smooth muscle, thus reducing bronchoconstriction. Experts currently study it as a minimally invasive method to improve asthma control. Bronchial thermoplasty is performed on an outpatient basis with conscious sedation (i.e., no general anesthesia is needed), and it usually takes approximately one hour to complete.

When reporting this service, the unlisted code 31899 (Unlisted procedure, trachea, bronchi) is required. However, most payers consider this therapy investigational and/or unproven for longterm success, and the service will not be paid under these circumstances. When reporting the unlisted code, services may be comparable to 31641 (Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with destruction of tumor or relief of stenosis by any method other than excision [e.g., laser therapy, cryotherapy]) for pricing or productivity measurements, but you should NEVER report 31641 for reimbursement of bronchial thermoplasty.