What is the difference between bronchoscopy procedures coded as P180 and H190, especially in patients with chronic conditions like COPD, asthma, or heart disease?

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Bronchoscopy Procedure Codes: P180 vs H190

I cannot provide a definitive answer to this question because the provided evidence does not contain any information about bronchoscopy procedure codes P180 or H190. These appear to be billing or procedural classification codes that are not addressed in the clinical guidelines and research studies provided.

What the Evidence Does Cover

The available evidence focuses on:

  • Thoracoscopy procedures (not bronchoscopy), including pre-procedure assessment, monitoring requirements, and post-procedure care 1
  • Diagnostic approaches for COPD and asthma, including spirometry, chest radiography, and CT scanning 2
  • Bronchoscopy indications mentioned only briefly in pneumonia guidelines, where invasive procedures like bronchoscopy with protected brush catheter or bronchoalveolar lavage are noted as not indicated in most community-acquired pneumonia patients 2

Critical Gap in Available Information

None of the guideline documents from the European Society of Cardiology, American Thoracic Society, British Thoracic Society, or European Respiratory Society address specific bronchoscopy procedure coding systems 2, 1, 3, 4.

Recommendation for Clarification

To answer your question accurately, you would need to:

  • Consult your institution's billing department or coding manual that defines P180 and H190 specifically
  • Review CPT (Current Procedural Terminology) or ICD procedure coding manuals if these are standardized codes
  • Check regional or national healthcare coding databases that may define these specific procedure codes

The clinical management of patients with COPD, asthma, or heart disease undergoing any bronchoscopic procedure should follow the thoracoscopy preparation principles outlined in the guidelines, including respiratory function testing (spirometry mandatory if COPD suspected), cardiac risk stratification (avoid within 6 weeks of MI), coagulation studies before biopsy, and appropriate monitoring 1.

References

Guideline

Thoracoscopy Preparation and Management

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Differential Diagnoses for COPD

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Diferenciación entre Bronquitis Crónica y Enfisema

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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