Need Clarification on 31622 with other procedures

ndriley10

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My thoracic surgeons like to bill 31622 if this is the first bronchoscopy performed on the patient however they usually go on to perform some type of biopsy. For example:

DESCRIPTION OF PROCEDURE: Initial flexible bronchoscopy was done after 1% lidocaine to vocal cords and the carina and secretions were suctioned from the airways. There was no evidence of endobronchial tumor and the right upper lobe stump was normal in appearance. The bronchoscope was removed and the EBUS scope passed into the airways. The only enlarged lymph node visualized within the mediastinum was the node visualized on CT scan in the R4 region. Multiple core needle biopsies were done with the 21 gauge EBUS needle of this lymph node. Initial on site interpretation revealed cells suspicious for lymphoma, the next pass raised suspicion of granulomas, therefore additional passes were done for cell block as well as lymphoma workup and also specimen collected for culture. The EBUS scope was then removed and the bronchoscope reinserted. Residual blood and secretions were suctioned from the airways and needle puncture sites were hemostatic.

I thought I read certain circumstances where you would bill separately for 31622 aside from the multiple endoscopy rules but now I can't find anything. Any thoughts??
 

dvance4210

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It sounds like you should bill for the initial bronch including the needle biopies (31625) with the add-on EBUS of 31620. I'll look in my articles to see if I have any other info for you.
 
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