Pulmonology Coding Alert

Question: My doctor wants me to bill 31623 and 31622, but I don't think I can bill both. Would you confirm for me?


Wyoming Subscriber


Answer: You are correct that you can't report both codes together if the pulmonologist performed one bronchoscopy with brushings. Code 31622 (Bronchoscopy, rigid or flexible, with or without fluoroscopic guidance; diagnostic, with or without cell washing [separate procedure]) represents a diagnostic bronchoscopy and is inherent in the procedure represented by 31623 (Bronchoscopy, rigid or flexible, with or without fluoroscopic guidance; with brushing or protected brushings).

You should always report the most extensive procedure when selecting from a single family of codes. In this case, a bronchoscopy with brushings is more extensive than a simple diagnostic bronchoscopy, so you should only report 31623.

You cannot report separate procedures even if the physician performed the diagnostic bronchoscopy at a separate session on the same date. The National Correct Coding Initiative bundles the diagnostic bronchoscopy into other bronchoscopies without the ability to unbundle the services when appropriate.