This page addresses follow-up questions and additional information pertinent to our webinar
Airway, Bronchoscopy, and Codes.
** The coding information and guidance are valid at the time of publishing. Learners are encouraged to research
subsequent official guidance in the areas associated with the topic as they can change rapidly.
Q: What is the difference between cell washing and a bronchoalveolar lavage (BAL)?
A: Bronchial alveolar lavage involves repeated instillation of sterile saline occurring in alequots (measurements) into the lower respiratory tract. ‘Washings’, refers to small amounts of instilled saline into the larger airways.
Q: When the procedure note states the stenosed bronchus was dilated and then a stent was placed via bronchoscopy, can I report both 31630 and 31636?
A: No – the dilation code is bundled into the stenting code, so in this case, for 1 bronchus being stented, only code 31636 should be reported.
Q: Is it OK to report code 31635 for a bronchoscopy with removal of a foreign body, with codes 31623 – for brushings and 31625 for a biopsy?
A: Yes, codes 31623, 31625 and 31635 may be reported with each other as these are considered distinct procedures, which do not overlap each another.
Looking for additional information on this topic?
Good Morning Shea:
I have a doctor who documented he did Flexible Bronchoscopy, went into right mainstem bronchus. The RML, RUL, RLL and LUL, LLL were inspected and there were small secretions noted, otherwise no mucosal lesions, erythema or abnormalities.
My question is this, I do not see anything documented about aspiration on the small secretions were noted. Can we still use CPT 31645.
Thank you for your guidance in this matter.
Kindest regards,
Hi Ramonita,
To report 31645, the physician passes a catheter through a channel in the bronchoscope and aspirates the tracheobronchial tree. Or the physician passes a needle through a channel in the bronchoscope into the fluid collection and aspirates fluid through the needle.
If aspiration was not performed, and no other procedures were performed, a diagnostic flexible bronchoscopy is coded with 31622.
We hope this helps!
The Haugen Academy Learning Team