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CPT Include fluoroscopic guidance or not

Luna

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I'm trying to understand the guidelines relating to coding bubble 31622 through 31651.

Guidelines under Trachea and Bronchi/Endoscopy state that codes "31622 - 31649 include fluoroscopic guidance when performed."

Code 31651 is also part of that bubble. It is an add on code just like 31649 is.

31649 is used with 31648. Both codes fall within the code range for "fluoroscopic guidance included when performed" instruction.

However, 31651 falls outside that instruction but is to be used with code 31647 which falls within the instruction. So, will 31651 include fluoroscopic guidance when performed or not?

I understand that some codes within a bubble may include something that others within the bubble do not. However, looking at the description of these codes, I'm am wondering if 31651 should have been included in the code range mentioned in the guidelines. At first I thought perhaps it was not included in the guideline instructions since it was an add-on code and so naturally, it applied without need of mention. But, 31649 is also an add-on code and is included in the instruction. And so, that made me question: What is it about code 31651 that excludes it from the guidelines that "fluoroscopic guidance is included when performed?"

Hoping someone knows, and can explain it to me. I had made a note in my manual that it does not include fluro, but now, I'm thinking it does.
 

Ruth Sheets

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The fluoroscopic guidance is included in the description of the main code of that bubble (31622). In other words, the full description of 31651 would be:
31651 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), each addition lobe (List separately in addition to code for primary procedures).
(Use 31651 in conjunction with 31647.)

The code range should have been expanded to read: Codes 31622-31651


include fluoroscopic guidance, when performed.

Also, for more "'proof", in the CPT index look up Fluoroscopy/ Guidance/ Chest/ Bronchoscopy, and see that 31651 is listed.



Luna, I'm impressed how you are going through the CPT manual with a fine-toothed comb. Not much gets by you, I'm sure!
 

Luna

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The fluoroscopic guidance is included in the description of the main code of that bubble (31622). In other words, the full description of 31651 would be:
31651 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), each addition lobe (List separately in addition to code for primary procedures).
(Use 31651 in conjunction with 31647.)

The code range should have been expanded to read: Codes 31622-31651

include fluoroscopic guidance, when performed.

Also, for more "'proof", in the CPT index look up Fluoroscopy/ Guidance/ Chest/ Bronchoscopy, and see that 31651 is listed.


Luna, I'm impressed how you are going through the CPT manual with a fine-toothed comb. Not much gets by you, I'm sure!

This is too funny.

I see that my question was posted May 29th and your reply on June 9th. Well, on June 4th I got meningitis and my head and memory were very foggy for sometime. Feeling better now in recent weeks, I have been reviewing everything I have studied up to where I left off in the respiratory chapter. I was going over my notes in the CPT manual and found "floro not included" written under code 31651. I asked myself why I made such a note. I read the guidelines again and went through this having the exact same questions come up in my head. So, I got online to see what I could find. A link to this forum thread came up. And what do you know...there I am asking the very same questions that were just going through my head. I'm so glad I posted my question when I did!!! Had I put off posting it, I'd still be lost.

Thank you so much Ruth for clarification. I also like the tip on how to double check on something like that by using the index and finding what range it provided for floro/guidance...
 

Ruth Sheets

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Luna, you made my day! And I had a wonderful day!
 
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