november 2015

2016 CPT Code Changes

There have been changes to the CPT codes that would be used for lymph node sampling/biopsies and lung cancer staging procedures. The procedures are a mediastinoscopy and endobronchial ultrasound or EBUS. The mediastinum is the thoracic body compartment above the diaphragm where the lungs, heart, trachea and esophagus are located. Surrounding these organs are a number of lymph nodes which are divided into “stations” for the purpose of identifying the location of where lung cancer may be present.

In 2015 there was one CPT code 39400 for a mediastinoscopy which included biopsies when performed. However, performance of this procedure has declined in each of the past 6 years due to the development of less invasive techniques such as the EBUS. In order to reflect this change and to capture the actual work being performed via mediastinoscopy techniques code 39400 has been deleted and new codes 39401 – Mediastinoscopy; includes biopsy(ies) of mediastinal mass when performed and 39402 – with lymph node biopsy(ies). Confirm the biopsy site, that being either a mediastinal mass or lymph node(s) when assigning these two CPT codes.

The Endobronchial ultrasound is two different techniques in one procedure. You have the bronchoscopy portion of the procedure where the endoscope is passed through the trachea and bronchi to examine the mucosal lining and areas within this tube like structure. Once completed a device with an ultrasound transducer is passed through the endoscope and this gives the surgeon the ability to see the surrounding soft tissue outside of the trachea/bronchus. If a tumor or mass is detected a needle can be deployed from an area just below the transducer which allows the surgeon to aspirate or biopsy the mass through the tracheal or bronchial wall in a minimally invasive technique. Refer to the CPT code descriptions for 31652-31654 to select the appropriate code based on the number of samplings and the location of the lesion(s).


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