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Endobronchial Ultrasound: Clinical Uses and Professional Reimbursements

Thomas R. Gildea, MD MS FACP FCCP; Katina Nicolacakis, MD FCCP
Author and Funding Information

Conflict of Interest: Dr. Gildea has presented to CMS on behalf of Olympus regarding technical reimbursement

Conflict of Interest: Dr. Nicolacakis is the Chair of American Thoracic Society Clinical Practice Committee and an ATS Advisor to the AMA Relative Value Scale Update Committee (RUC).

Thomas R. Gildea MD MS FACP FCCP, Head, Section of Bronchoscopy Respiratory Institute, Department of Pulmonary, Allergy and Critical Care Medicine & Transplant Center, Cleveland Clinic 9500 Euclid Ave Desk M2-141, Cleveland, OH 44195.


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016. doi:10.1016/j.chest.2016.05.009
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Abstract

Endobronchial Ultrasound (EBUS) has become an invaluable tool in the diagnosis of patients with a variety of thoracic abnormalities. The majority of EBUS procedures are used to diagnose and stage mediastinal and hilar abnormalities as well as peripheral pulmonary targets with a probe based technology. Nearly 1000 articles have been written about its use and utility. New Current Procedural Terminology (CPT®) codes have been introduced in 2016 to better capture the work and clinical use associated with the various types of EBUS procedures. The existing 31620 code has been deleted and replaced by three new codes, 31652, 31653 and 31654. These new codes have been through the valuation process and the new rule for reimbursement has been active since January 1st 2016 and with National Correct Coding Initiative (NCCI) correction as of April 1, 2016. The impact of these new codes will result in a net reduction in professional and technical reimbursement. This article describes the current use of EBUS and explains the current codes and professional reimbursement.


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