Q&A: Billing for bronchoscopy due to abnormal chest X-ray

Q. A patient came to our endoscopy suite for a bronchoscopy due to an abnormal chest X-ray. The physician documented that a transbronchial lung biopsy was obtained from the right upper lobe and the right lower lobe. What would be the correct CPT® codes to report?

A. CPT 31628 (Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe) and CPT 31632 (with transbronchial lung biopsy(s) each additional lobe) would be reported.

The description for CPT 31632 states “each additional lobe,” which indicates that this code does not describe a full procedure or a primary procedure. There is a specific instruction or parenthetical note with CPT 31628 stating to report any transbronchial lung biopsies performed on an additional lobe with CPT 31632. When we look at the instructional notes with CPT 31632, we find instruction that states, “Use 31632 in conjunction with 31628.” If both codes are not reported, the edit will trigger and require resolution.

For more information, see Medicare Billing Edits: A Guide to Regulation, Research, and Resolution.

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