What we bill · Bronchoscopy & interventional
One scope session, four procedures — and a maze of bundling edits
Bronchoscopy is where pulmonology's highest-value claims meet its most technical billing rules, and where inexperienced billers leave the most money behind. Here's how the bundling actually works.
Compare free quotesNCCI edits decide what gets paid
A diagnostic bronchoscopy (31622) with brushing (31623), lavage (31624), endobronchial biopsy (31625), or transbronchial biopsy (31628) isn't four automatic payments. NCCI edits bundle some combinations, allow others, and permit modifier 59 only where the work was genuinely distinct. Billed wrong in either direction, the practice is choosing between a denial and a compliance risk.
The standard to demand: edit-pair review on every multi-procedure session before submission — what's separately billable as documented, what needs the modifier, and what the op note must say to support it.
The rest of the interventional picture
EBUS and navigational procedures coded from the documented approach. Prior authorization for biopsies confirmed before the case — an unauthorized biopsy is usually unpaid work. Facility vs. professional component sorted by where the case was done. And appeals that quote the payer's own bundling policy back, with the op note attached.
Bronchoscopy billing, answered
Why did only one code from our bronchoscopy get paid?
Almost always NCCI bundling: the payer's edits folded the additional procedures into the primary. Some bundles are correct; many are appealable when documentation shows distinct work. The answer is in the op note and the edit pair — a competent biller checks both before deciding.
Does bronchoscopy need prior authorization?
Diagnostic bronchoscopy often doesn't; bronchoscopy with biopsy frequently does, depending on payer and setting. The requirement should be verified per payer at scheduling, never assumed.
Bundling is where the money hides
Get competitive quotes, then ask each biller how they review NCCI edit pairs before submission.
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