2022 Coding & Payment Quick Reference - Boston Scientific

2022 Coding & Payment Quick Reference

Lung and Airway Management Coding Guide

Payer policies will vary and should be verified prior to treatment for limitations on diagnosis, coding or site of service requirements. The coding options listed within this guide are commonly used codes and are not intended to be an all-inclusive list. We recommend consulting your relevant manuals for appropriate coding options.

The following codes are thought to be relevant to airway management procedures and are referenced throughout this guide. All rates shown are 2022 Medicare national average payments. Actual reimbursement will vary for each provider and institution for a variety of reasons including geographic difference in labor and non-labor costs, hospital teaching status, and/or proportion of low-income patients. On average, private payers pay more than Medicare.5

Please note: this coding information may include codes for procedures for which Boston Scientific currently offers no cleared or approved products. In those instances, such codes have been included solely in the interest of providing users with comprehensive coding information and are not intended to promote the use of any Boston Scientific products for which they are not cleared or approved, including the EXALTTM Model B.

Bedside Bronchoscopy and Airway Management

CPT? Code1

Code Description

Bronchial Alveolar Lavage, Therapeutic Aspiration, Endobronchial Biopsy and Airway Inspection

31615

Tracheobronchoscopy through established tracheostomy incision

31622

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)

31623

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with brushing or protected brushings

31624

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage

31625

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial or endobronchial biopsy(s), single or multiple sites

31645

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, initial

31646

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, subsequent, same hospital stay

Work RVUs2

1.84 2.53 2.63 2.63 3.11 2.88 2.78

Medicare National Physician Payment CY

2022 (In-Facility),2

$117 $133 $134 $135

$158

$148

$143

ICD-10

0B9C8ZX 0B9C8ZZ 0B9D8ZX 0B9D8ZZ 0B9F8ZX 0B9F8ZZ 0B9G8ZX 0B9G8ZZ 0B9H8ZX 0B9H8ZZ 0B9J8ZX 0B9J8ZZ 0B9K8ZX 0B9K8ZZ 0B9L8ZX

Description

Drainage of Right Upper Lung Lobe, Via Natural or Artificial Opening Endoscopic, Diagnostic Drainage of Right Upper Lung Lobe, Via Natural or Artificial Opening Endoscopic Drainage of Right Middle Lung Lobe, Via Natural or Artificial Opening Endoscopic, Diagnostic Drainage of Right Middle Lung Lobe, Via Natural or Artificial Opening Endoscopic Drainage of Right Lower Lung Lobe, Via Natural or Artificial Opening Endoscopic, Diagnostic Drainage of Right Lower Lung Lobe, Via Natural or Artificial Opening Endoscopic Drainage of Left Upper Lung Lobe, Via Natural or Artificial Opening Endoscopic, Diagnostic Drainage of Left Upper Lung Lobe, Via Natural or Artificial Opening Endoscopic Drainage of Lung Lingula, Via Natural or Artificial Opening Endoscopic, Diagnostic Drainage of Lung Lingula, Via Natural or Artificial Opening Endoscopic Drainage of Left Lower Lung Lobe, Via Natural or Artificial Opening Endoscopic, Diagnostic Drainage of Left Lower Lung Lobe, Via Natural or Artificial Opening Endoscopic Drainage of Right Lung, Via Natural or Artificial Opening Endoscopic, Diagnostic Drainage of Right Lung, Via Natural or Artificial Opening Endoscopic Drainage of Left Lung, Via Natural or Artificial Opening Endoscopic, Diagnostic

1

0B9L8ZZ 0B9M8ZX 0B9M8ZZ 0BB28ZX 0BB38ZX 0BB48ZX 0BB58ZX 0BB68ZX 0BB78ZX 0BB88ZX 0BB98ZX 0BBB8ZX 0BD38ZX 0BD48ZX 0BD58ZX 0BD68ZX 0BD78ZX 0BJ08ZZ 0BJ18ZZ 0BJK8ZZ 0BJL8ZZ

Drainage of Left Lung, Via Natural or Artificial Opening Endoscopic Drainage of Bilateral Lungs, Via Natural or Artificial Opening Endoscopic, Diagnostic Drainage of Bilateral Lungs, Via Natural or Artificial Opening Endoscopic Excision of Carina, Via Natural or Artificial Opening Endoscopic, Diagnostic Excision of Right Main Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic Excision of Right Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic Excision of Right Middle Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic Excision of Right Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic Excision of Left Main Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic Excision of Left Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic Excision of Lingula Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic Excision of Left Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic Extraction of Right Main Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic Extraction of Right Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic Extraction of Right Middle Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic Extraction of Right Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic Extraction of Left Main Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic Inspection of Tracheobronchial Tree, Via Natural or Artificial Opening Endoscopic Inspection of Trachea, Via Natural or Artificial Opening Endoscopic Inspection of Right Lung, Via Natural or Artificial Opening Endoscopic Inspection of Left Lung, Via Natural or Artificial Opening Endoscopic

MS-DRG

Description

Non-OR procedures - do not affect the MS-DRG

Hospital Inpatient Medicare National Average Payment4

will vary by diagnosis and clinical situation

CPT? Code1

Code Description

Emergency Intubation

31500

Intubation, endotracheal, emergency procedure

Percutaneous Tracheostomy

31600

Tracheostomy, planned (separate procedure);

31601

Tracheostomy, planned (separate procedure); younger than 2 years

31603

Tracheostomy, emergency procedure; transtracheal

31605

Tracheostomy, emergency procedure; cricothyroid membrane

Work RVUs2

3.00

5.56 8.00 6.00 6.45

Medicare National Physician Payment CY

2022 (In-Facility),2

$144

$312 $457 $327 $340

ICD-10 0B113F4 0B114F4

Description Bypass Trachea to Cutaneous with Tracheostomy Device, Percutaneous Approach Bypass Trachea to Cutaneous with Tracheostomy Device, Percutaneous Endoscopic Approach

MS-DRG

003

004

011 012 013 166 167 168

Description

ECMO or Tracheostomy with Mechanical Ventilation >96 Hours or Principal Diagnosis Except Face, Mouth and Neck with Major O.R. Tracheostomy with Mechanical Ventilation >96 Hours or Principal Diagnosis Except Face, Mouth and Neck without Major O.R. Tracheostomy for Face, Mouth, and Neck Diagnoses or Laryngectomy with MCC Tracheostomy for Face, Mouth, and Neck Diagnoses or Laryngectomy with CC Tracheostomy for Face, Mouth, and Neck Diagnoses or Laryngectomy without CC/MCC Other Respiratory System O.R. Procedures with MCC Other Respiratory System O.R. Procedures with CC Other Respiratory System O.R. Procedures without CC/MCC

Hospital Inpatient Medicare National Average Payment4 $125,988

$78,621

$33,113 $25,275 $17,962 $24,554 $11,993 $8,931

2

Thoracic Surgery

CPT? Code1 Diagnostic 32096 32097 32098 32100 32601 32604 32606 32607 32608 32609 Excision 32110 32120 32140 32501 32150 32151 32160 32440 32442 32445 32480 32482 32484

32486

32488

32491

+32501 32505 +32506

Code Description

Thoracotomy, with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional), unilateral

Thoracotomy, with diagnostic biopsy(ies) of lung nodule(s) or mass(es) (eg, wedge, incisional), unilateral

Thoracotomy, with biopsy(ies) of pleura

Thoracotomy; with exploration

Thoracoscopy, diagnostic (separate procedure); lungs, pericardial sac, mediastinal or pleural space, without biopsy

Thoracoscopy, diagnostic (separate procedure); pericardial sac, with biopsy

Thoracoscopy, diagnostic (separate procedure); mediastinal space, with biopsy

Thoracoscopy; with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional), unilateral

Thoracoscopy; with diagnostic biopsy(ies) of lung nodule(s) or mass(es) (eg, wedge, incisional), unilateral

Thoracoscopy; with biopsy(ies) of pleura

Thoracotomy; with control of traumatic hemorrhage and/or repair of lung tear

Thoracotomy; for postoperative complications

Thoracotomy; with cyst(s) removal, includes pleural procedure when performed

Thoracotomy; with resection-plication of bullae, includes any pleural procedure when performed

Thoracotomy; with removal of intrapleural foreign body or fibrin deposit

Thoracotomy; with removal of intrapulmonary foreign body

Thoracotomy; with cardiac massage

Removal of lung, pneumonectomy

Removal of lung, pneumonectomy; with resection of segment of trachea followed by broncho-tracheal anastomosis (sleeve pneumonectomy)

Removal of lung, pneumonectomy; extrapleural

Removal of lung, other than pneumonectomy; single lobe (lobectomy)

Removal of lung, other than pneumonectomy; 2 lobes (bilobectomy)

Removal of lung, other than pneumonectomy; single segment (segmentectomy)

Removal of lung, other than pneumonectomy; with circumferential resection of segment of bronchus followed by broncho-bronchial anastomosis (sleeve lobectomy)

Removal of lung, other than pneumonectomy; with all remaining lung following previous removal of a portion of lung (completion pneumonectomy)

Removal of lung, other than pneumonectomy; with resection-plication of emphysematous lung(s) (bullous or non-bullous) for lung volume reduction, sternal split or transthoracic approach, includes any pleural procedure, when performed

Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (List separately in addition to code for primary procedure)

Thoracotomy; with therapeutic wedge resection (eg, mass, nodule), initial

Thoracotomy; with therapeutic wedge resection (eg, mass or nodule), each additional resection, ipsilateral (List separately in addition to code for primary procedure)

MPFS

$814 $816 $773 $825 $312 $486 $469 $312 $384 $260

$1,502 $889 $1,008 $246 $1,030 $1,023 $812 $1,598 $3,100 $3,582 $1,507 $1,613 $1,460

$2,376

$2,428

$1,498

$246 $949 $159

2022 Medicare National Average Payment,2,3

APC

APC Description

APC Rate

ASC

Inpatient only

Inpatient only

Inpatient only Inpatient only

5361

Thoracoscopy

$5,168

N/A

5361

Thoracoscopy

$5,168

N/A

5361

Thoracoscopy

$5,168

N/A

5361

Thoracoscopy

$5,168

N/A

5361

Thoracoscopy

$5,168

N/A

5361

Thoracoscopy

$5,168

N/A

Inpatient only Inpatient only Inpatient only

Inpatient only Inpatient only Inpatient only Inpatient only Inpatient only Inpatient only Inpatient only Inpatient only Inpatient only Inpatient only

Inpatient only

Inpatient only

Inpatient only

Inpatient only Inpatient only Inpatient only

3

+32507 32650 32651 32652

32653 32654 32655 32656 32658

32659 32661 32662 32663 32664 32665 32666

+32667

+32668

Thoracotomy; with diagnostic wedge resection followed by anatomic lung resection (List separately in addition to code for primary procedure)

Thoracoscopy, surgical; with pleurodesis (eg, mechanical or chemical)

Thoracoscopy, surgical; with partial pulmonary decortication

Thoracoscopy, surgical; with total pulmonary decortication, including intrapleural pneumonolysis

Thoracoscopy, surgical; with removal of intrapleural foreign body or fibrin deposit

Thoracoscopy, surgical; with control of traumatic hemorrhage

Thoracoscopy, surgical; with resection-plication of bullae, includes any pleural procedure when performed

Thoracoscopy, surgical; with parietal pleurectomy

Thoracoscopy, surgical; with removal of clot or foreign body from pericardial sac

Thoracoscopy, surgical; with creation of pericardial window or partial resection of pericardial sac for drainage

Thoracoscopy, surgical; with excision of pericardial cyst, tumor, or mass

Thoracoscopy, surgical; with excision of mediastinal cyst, tumor or mass

Thoracoscopy, surgical; with lobectomy (single lobe)

Thoracoscopy, surgical; with thoracic sympathectomy

Thoracoscopy, surgical; with esophagomyotomy (Heller type)

Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass, nodule), initial, unilateral

Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass, nodule), each additional resection, ipsilateral (List separately in addition to code for primary procedure)

Thoracoscopy, surgical; with diagnostic wedge resection followed by anatomic lung resection (List separately in addition to code for primary procedure)

$159 $680 $1,115 $1,690

$1,079 $1,185 $973 $819 $728

$746 $814 $909 $1,422 $863 $1,252 $886

$159

$160

ICD-10

01B30ZZ 01BL0ZZ 01BL4ZZ 02BN4ZX 02BN4ZZ 02CN4ZZ 02QN4ZZ 07B74ZZ 07TM4ZZ 0B5C3ZZ 0B5D3ZZ 0B5F3ZZ 0B5G3ZZ 0B5H3ZZ 0B5J3ZZ 0B5K3ZZ 0B5L3ZZ 0B5M3ZZ 0B5N3ZZ 0B5N4ZZ 0B5P3ZZ 0B5P4ZZ

Description

Excision of Brachial Plexus, Open Approach Excision of Thoracic Sympathetic Nerve, Open Approach Excision of Thoracic Sympathetic Nerve, Percutaneous Endoscopic Approach Excision of Pericardium, Percutaneous Endoscopic Approach, Diagnostic Excision of Pericardium, Percutaneous Endoscopic Approach Extirpation of Matter from Pericardium, Percutaneous Endoscopic Approach Repair Pericardium, Percutaneous Endoscopic Approach Excision of Thorax Lymphatic, Percutaneous Endoscopic Approach Resection of Thymus, Percutaneous Endoscopic Approach Destruction of Right Upper Lung Lobe, Percutaneous Approach Destruction of Right Middle Lung Lobe, Percutaneous Approach Destruction of Right Lower Lung Lobe, Percutaneous Approach Destruction of Left Upper Lung Lobe, Percutaneous Approach Destruction of Lung Lingula, Percutaneous Approach Destruction of Left Lower Lung Lobe, Percutaneous Approach Destruction of Right Lung, Percutaneous Approach Destruction of Left Lung, Percutaneous Approach Destruction of Bilateral Lungs, Percutaneous Approach Destruction of Right Pleura, Percutaneous Approach Destruction of Right Pleura, Percutaneous Endoscopic Approach Destruction of Left Pleura, Percutaneous Approach Destruction of Left Pleura, Percutaneous Endoscopic Approach

Inpatient only Inpatient only Inpatient only Inpatient only Inpatient only Inpatient only Inpatient only Inpatient only Inpatient only Inpatient only Inpatient only Inpatient only Inpatient only Inpatient only Inpatient only Inpatient only Inpatient only Inpatient only

4

0B9C00Z 0B9C0ZZ 0B9D00Z 0B9D0ZZ 0B9F00Z 0B9F0ZZ 0B9G00Z 0B9G0ZZ 0B9H00Z 0B9H0ZZ 0B9J00Z 0B9J0ZZ 0B9K00Z 0B9K0ZZ 0B9N0ZZ 0B9P0ZZ 0BB10ZZ 0BB30ZZ 0BB70ZZ 0BBC0ZX 0BBC0ZZ 0BBC4ZX 0BBC4ZZ 0BBD0ZX 0BBD0ZZ 0BBD4ZX 0BBD4ZZ 0BBF0ZX 0BBF0ZZ 0BBF4ZX 0BBF4ZZ 0BBG0ZX 0BBG0ZZ 0BBG4ZX 0BBG4ZZ 0BBH0ZX 0BBH0ZZ 0BBH4ZX 0BBH4ZZ 0BBJ0ZX 0BBJ0ZZ 0BBJ4ZX 0BBJ4ZZ 0BBK0ZX 0BBK0ZZ 0BBK4ZX 0BBK4ZZ 0BBL0ZX 0BBL0ZZ 0BBL4ZX 0BBL4ZZ 0BBM0ZX 0BBM0ZZ

Drainage of Right Upper Lung Lobe with Drainage Device, Open Approach Drainage of Right Upper Lung Lobe, Open Approach Drainage of Right Middle Lung Lobe with Drainage Device, Open Approach Drainage of Right Middle Lung Lobe, Open Approach Drainage of Right Lower Lung Lobe with Drainage Device, Open Approach Drainage of Right Lower Lung Lobe, Open Approach Drainage of Left Upper Lung Lobe with Drainage Device, Open Approach Drainage of Left Upper Lung Lobe, Open Approach Drainage of Lung Lingula with Drainage Device, Open Approach Drainage of Lung Lingula, Open Approach Drainage of Left Lower Lung Lobe with Drainage Device, Open Approach Drainage of Left Lower Lung Lobe, Open Approach Drainage of Right Lung with Drainage Device, Open Approach Drainage of Right Lung, Open Approach Drainage of Right Pleura, Open Approach Drainage of Left Pleura, Open Approach Excision of Trachea, Open Approach Excision of Right Main Bronchus, Open Approach Excision of Left Main Bronchus, Open Approach Excision of Right Upper Lung Lobe, Open Approach, Diagnostic Excision of Right Upper Lung Lobe, Open Approach Excision of Right Upper Lung Lobe, Percutaneous Endoscopic Approach, Diagnostic Excision of Right Upper Lung Lobe, Percutaneous Endoscopic Approach Excision of Right Middle Lung Lobe, Open Approach, Diagnostic Excision of Right Middle Lung Lobe, Open Approach Excision of Right Middle Lung Lobe, Percutaneous Endoscopic Approach, Diagnostic Excision of Right Middle Lung Lobe, Percutaneous Endoscopic Approach Excision of Right Lower Lung Lobe, Open Approach, Diagnostic Excision of Right Lower Lung Lobe, Open Approach Excision of Right Lower Lung Lobe, Percutaneous Endoscopic Approach, Diagnostic Excision of Right Lower Lung Lobe, Percutaneous Endoscopic Approach Excision of Left Upper Lung Lobe, Open Approach, Diagnostic Excision of Left Upper Lung Lobe, Open Approach Excision of Left Upper Lung Lobe, Percutaneous Endoscopic Approach, Diagnostic Excision of Left Upper Lung Lobe, Percutaneous Endoscopic Approach Excision of Lung Lingula, Open Approach, Diagnostic Excision of Lung Lingula, Open Approach Excision of Lung Lingula, Percutaneous Endoscopic Approach, Diagnostic Excision of Lung Lingula, Percutaneous Endoscopic Approach Excision of Left Lower Lung Lobe, Open Approach, Diagnostic Excision of Left Lower Lung Lobe, Open Approach Excision of Left Lower Lung Lobe, Percutaneous Endoscopic Approach, Diagnostic Excision of Left Lower Lung Lobe, Percutaneous Endoscopic Approach Excision of Right Lung, Open Approach, Diagnostic Excision of Right Lung, Open Approach Excision of Right Lung, Percutaneous Endoscopic Approach, Diagnostic Excision of Right Lung, Percutaneous Endoscopic Approach Excision of Left Lung, Open Approach, Diagnostic Excision of Left Lung, Open Approach Excision of Left Lung, Percutaneous Endoscopic Approach, Diagnostic Excision of Left Lung, Percutaneous Endoscopic Approach Excision of Bilateral Lungs, Open Approach, Diagnostic Excision of Bilateral Lungs, Open Approach

5

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