billing bronchs

amsmith

Networker
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Yucaipa, CA
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I was told that we can bill bronchs not so much as bilateral (50) where it is a mirror image, but as a unilateral so that mucosal biopsies in both the RUL and the LLL would be billed as 31625x2. Can anyone help me find proof of this? Encoder Pro and Codecorrect say that more than one can be billed... I need your help. Thank you in advance. Anna
 

ciphermed

Guru
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31625 should only be billed once per encounter; CPT assistant '99 indicates bronchoscopy is inherently bilateral, CPT assistant '04 indicates "...code is intended to be reported once, regardless of whether one or more biopsies are performed on a single site or multiple site".

CMS has a Medically Unlikely Edit (MUE) associated with CPT 31625 in which the daily max is = 1 unit.

Hope this helps,
 
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