bronchoscopy-wedge resection

cynthiabrown

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i was reviewing an audit from 2011..sorry ,wasn't specific about that, so it is ok to bill dx bronchoscopy before a vat procedure for previously confirmed ca ?
 

Torilinne

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This is a touchy one......if ca was previously confirmed, I'm wondering why the diagnostic bronchoscopy? Chapter Six of CCI states.....

"If an endoscopy is performed for purposes of an initial diagnosis on the same day as the open procedure, the endoscopy is separately reported. Assuming that a diagnostic bronchoscopy has already been performed for diagnosis and biopsy and the surgeon is simply evaluating for anatomic assessment......, the bronchoscopy would not be separately reported. Essentially, this "scout" endoscopy represents a part of the assessment of the surgical field to establish anatomical landmarks, extent of disease, etc. If an endoscopic procedure is done as part of an open procedure, it is not separately reported. If the endoscopy is performed for diagnostic purposes immediately prior to a more definitive procedure, the 58 modifier may be utilized to indicate that these procedures are staged or planned services."

Hope this helps a little?

Torilinne
SCC, CPC, CGIC
 

cynthiabrown

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my thoughts exactly.............i have that chapter printed. it was billed out and originally denied but in the end it was paid. But to clarify, if a dx scope is done prior to procedure for diagnosing, it is billed with 58 modifier?
 
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