Staged Bronchoscopy

ssprinkle

Networker
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If Dr. does Bronchoscopy with bx then Dr determines, based on that specimen, that more extensive work to be done (still Bronchoscopically) that same day/encounter, Can you bill both with a 78 on the second procedure? or only bill the more extensive Bronch procedure only?
 

Lujanwj

Guru
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You'll use -58 on the biopsy

See NCCI Policy Guidelines Chpt 1

"If the biopsy is performed on the same lesion on which a more extensive procedure is performed, it is separately reportable only if the biopsy is utilized for immediate pathologic diagnosis prior to the more extensive procedure, and the decision to proceed with the more extensive procedure is based on the diagnosis established by the pathologic examination. The biopsy is not separately reportable if the pathologic examination at the time of surgery is for the purpose of assessing margins of resection or verifying resectability. When separately reportable modifier 58 may be reported to indicate that the biopsy and the more extensive procedure were planned or staged procedures."
 
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