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bronchoscopy as guidance for perc trach

  1. Question bronchoscopy as guidance for perc trach
    Medical Coding Books
    the surgeon used a bronchoscope to assist w/trach placement. it was advanced down the et tube. report reads:No copious amounts of secretions were needed to clear prior to procedure. Lung fields were visualized. Both mainstem bronchi were open and patent. Then the ET tube was removed to 19 and then re-visualized for the surgeon who was placing the tracheostomy, not visualizing a finger tip, or the ET tube was backed up to 16. Then noticing movement of the tracheal rings, 1% lidocaine was administered and the tracheostomy started. Then, using a finder needle, the finder needle was visualized as it punctured through the tracheal rings and then visualized the wire going south towards the mainstem bronchi, after which several dilators were used and re-visualized as they went inferior towards the mainstem bronchi, after which also visualized the placement of the 8-0 Shiley cuffed trach, after which the trach was placed. The ET tube was removed and the bronchoscope introduced through the 8-0 Shiley to confirm appropriate placement of the trach

    bottom line-- is this just a diagnostic bronch 31622?

  2. Default Old question but want to answer for others.
    According to the NCCI Narrative Policy Manual, "If laryngoscopy is required for placement of a tracheostomy, the tracheostomy (CPT codes 31600-31610) may be reported. The laryngoscopy is not separately reportable."

    I know this post said bronchoscopy, but there is a bundling edit in place for 31600 and 31622. If it were done for something other than guidance of the tracheostomy then perhaps you could unbundle. I would check the NCCI Guidelines in that case.

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