Pulmonology Coding Alert

Question: Should I use 31646 when my pulmonologist performs a therapeutic bronchoscopy on the same day as another bronchoscopy, or is 31646 used for the same hospital admission?


Oregon Subscriber


Answer: You should use 31646 (Bronchoscopy [rigid or flexible]; with therapeutic aspiration of tracheobronchial tree, subsequent) to report the second therapeutic bronchoscopy that your pulmonologist performs on the same day that he performed another therapeutic bronchoscopy earlier.
 
If a patient requires subsequent therapeutic bronchoscopies during the same hospitalization, you should use 31646 to report those as well. To code the initial therapeutic bronchoscopy, use 31645 (Bronchoscopy [rigid or flexible]; with therapeutic aspiration of tracheobronchial tree, initial [e.g., drainage of lung abscess]).

Codes 31645 and 31646 have zero-day global periods, meaning you should only report them once per day. This might lead you to believe that you can report 31645 many times throughout a single hospitalization, but insurer rules may contradict this.