Wiki Help with code 31635

[knperry]

Hello all! I need some help with the surgery mentioned below. I came up with code 31635 but I'm not sure if mucous is considered a foreign body. Any help will greatly be appreciated.

Reason For Procedure: Possible mucous plugging, prolonged ventilatory wean.

History for present illness: This is an 18 yar old fremale, who presented after a motor vehicle collision with a T12 burst fracture, who went to the operating room for an anterior and a subsequent posterior thoracic spinal repair. she has had difficulties weaning from the ventilator and had radiographic imaging that was concerning for possible mucous plugging and was felt to potentially benefit from bronchoscopy. Consent was obtained from the father due to the patient being intubated.

Procedure: Time-out was performed, verifying correct patient, site and procedure. Bronchoscope was introduced into the endotracheal tube and the airway examined. Attention was focused primarily on the left lung given her chest x-ray finding and a minimal amount of thin secretions were able to be suctioned from the left primary and secondary bronchi. The patient tolerated the procdure well. There were no complicaions.

 

[drooth]

It's been a while since I coded bronchoscopies, but this looks like a simple "just looking" procedure. As I understand it, mucous/secretions must be cleared out of the way so the endoscopist can get a good view of the tissue he/she is examining. You would not consider that a 'foreign body'. No lavage was performed. No biopsies were taken. This looks like a simple 31622. I do remember some physicians trying to tell me this suctioning could be interpreted as a 31645 (if the 1st time it's performed,) or a 31646 (for subsequent suctioning.) I hope someone else with more current information checks in here to give you an opinion, but my initial impression is 31622.

 

[knperry]

Thank you so much @ Drooth!