Bronchoscopy CPT Code (2022) Description, Guidelines, Reimbursement, Modifiers & Example

Bronchoscopy CPT code(s) are listed in this article. This is a procedure that allows the physician to examine the lungs and airways. A tiny tube (bronchoscope) is pushed into the nose or mouth, down to the throat, and into the lungs during bronchoscopy. The first procedure performed with any hospitalization is a therapeutic bronchoscopy. A therapeutic bronchoscopy will be completed later that day or the next day but within the same hospitalization.

Bronchoscopy CPT Code Summary

A flexible fiberoptic or rigid bronchoscope is delivered through the nasal or oral cavity under a suitable anesthetic to observe the airway. The bronchoscope is inserted and moved into the nasal or oral cavities, past the larynx, to investigate the bronchus.

The bronchoscope can acquire cell washings after diagnostic inspection of the bronchus. Brushings or protected brushings through the scope are used to retrieve sample lung tissue in some circumstances.

Bronchial alveolar lavage, which allows lung tissue to be sampled by irrigating with saline and suctioning the fluid, is sometimes included in bronchoscopy. When fluoroscopic guidance is used, these codes are included.

Bronchoscopy CPT Code Description & Coding Guidelines

The following Bronchoscopy CPT code(s) are used to code related procedures: 

CPT codes range from 00400 to 00529 and are used for anesthesia for chest/pectoral girdle treatments.

CPT 00520 is used for anesthesia for closed-chest procedures; (including bronchoscopy) not otherwise specified.

CPT 0495T is used for initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by a physician, including physiological and laboratory assessment (e.g., pulmonary artery flow, pulmonary artery pressure, left atrial pressure, pulmonary vascular resistance, mean/peak and plateau airway pressure, dynamic compliance and perfusate gas analysis), including bronchoscopy and X-ray; first two hours in the sterile field. 

CPT 0496T is used for initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by the physician or qualified health care professional, including physiological and laboratory assessment (e.g., pulmonary artery flow, pulmonary artery pressure, left atrial pressure, pulmonary vascular resistance, mean/peak and plateau airway pressure, dynamic compliance and perfusate gas analysis), including bronchoscopy and X-ray; each additional hour. 

CPT 31615 is used for tracheobronchoscopy through established tracheostomy incision.

CPT 31622 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance; diagnostic, with cell washing.

CPT 31623 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance; with brushing or protected brushings.

CPT 31624 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance; with bronchial alveolar lavage.

CPT 31625 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance with bronchial or endobronchial biopsy, single or multiple sites.

CPT 31626 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance; with the placement of fiducial markers, single or multiple.

CPT 31627 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance, with computer-assisted, image-guided navigation. 

CPT 31628 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance, with transbronchial lung biopsy(s), single lobe.

CPT 31629 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance, with transbronchial needle aspiration biopsies, trachea, main stem, and lobar bronchus.

CPT 31630 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance, with tracheal/bronchial dilation or closed fracture reduction.

CPT 31631 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance, with the placement of a tracheal stent(s) (includes tracheal/bronchial dilation as required).

CPT 31632 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance, with transbronchial lung biopsy(s) for each additional lobe. 

CPT 31633 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance, with transbronchial needle aspiration biopsy(s) for each additional lobe. 

CPT 31634 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance, balloon occlusion, and an air leak assessment, with the administration of occlusive substance (e.g., fibrin glue).

CPT 31635 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance, to remove the foreign body.

CPT 31636 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance, with the placement of a bronchial stent(s) (includes tracheal/bronchial dilation as required), initial bronchus.

CPT 31637 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance; each additional major bronchus is stented.

CPT 31638 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance, with revision of tracheal or bronchial stent inserted at previous session (includes tracheal/bronchial dilation as required).

CPT 31640 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance, with excision of the tumor.

CPT 31641 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance, with the destruction of tumor or relief of stenosis by any method other than excision (e.g., laser therapy, cryotherapy).

CPT 31643 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance, with a catheter(s) placement for intracavitary radioelement application.

CPT 31645 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance, with the initial therapeutic aspiration of the tracheobronchial tree.

CPT 31646 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance, with the therapeutic aspiration of the tracheobronchial tree, next, same hospital stay.

CPT 31647 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance, balloon occlusion, air leak assessment, airway sizing, and insertion of bronchial valve(s) and initial lobe.

CPT 31648 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance, with the removal of the bronchial valve(s) and the initial lobe.

CPT 31649 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance, with the removal of bronchial valve(s) and each additional lobe. 

CPT 31651 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance, balloon occlusion, air leak assessment, airway sizing, and insertion of bronchial valve(s), each additional lobe. 

CPT 31652 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance, with endobronchial ultrasound (EBUS) guided trans-tracheal and transbronchial sampling (e.g., aspiration/biopsy), one or two mediastinal and hilar lymph node stations or structures.

CPT 31653 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance, with endobronchial ultrasound (EBUS) guided trans-tracheal and transbronchial sampling (e.g., aspiration/biopsy), three or more mediastinal and hilar lymph node stations or structures.

CPT 31654 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance, with transendoscopic endobronchial ultrasound during bronchoscopy diagnostic or therapeutic interventions for peripheral lesions.

CPT 31660 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance; with bronchial thermoplasty, one lobe.

CPT 31661 is used for bronchoscopy, rigid or flexible, including fluoroscopic guidance; with bronchial thermoplasty, two or more lobes.

CPT code ranges 31717-31899 are used for respiratory procedures.

CPT code 31725 is used for catheter aspiration, tracheobronchial with fiberscope, and bedside.

CPT code 31899 is used for unlisted procedures, trachea, and bronchi.

CPT code range 32900-32997 is used for chest and respiratory procedures.

CPT code 32997: Total lung lavage (unilateral).

When medically necessary, report moderate (conscious) sedation provided by the performing physician with 99151-99153. When provided by another physician, report 99155–99157.

Note that 31622, a separate procedure, is usually a component of more complex service and is not identified separately. It may be reported alone or with other unrelated processes/services.

If performed independently, list the code; if completed with other procedures/services, record the code and append modifier 59 or an X {EPSU} modifier. To report the appropriate endoscopy, the provider should examine each anatomic site.

Diagnostic endoscopy includes diagnostic endoscopy; however, diagnostic endoscopy can be identified separately in the same surgical session as an open procedure. Fluoroscopic guidance is not reported separately.

For bronchoscopy performed through a tracheostomy tube or endotracheal tube with bronchial alveolar lavage, report 31624 with modifier 52 appended.

Since the bronchoscope was not passed through the nose or mouth and an existing tube was used to access the bronchus, append modifier 52 for reduced services.

Bronchoscopy CPT Code Modifiers

The following are modifiers commonly used with a Bronchoscopy CPT code:

Modifier 22 is used when the procedure takes longer than routine procedural services.

Modifier 51 is used when multiple procedures are performed at a time.

In some circumstances, modifier 52 is used when some circumstances’ procedure is partially reduced. 

Modifier 53 is used when the surgical or diagnostic procedure is discontinued after starting the process due to some circumstances.

When this procedure is performed in a global period, modifier 58 is used. It may be staged or related to a system or service by the same physician or other QHC professionals during the postoperative period.

Modifier 59 is used when other distinct procedural services are performed other than E/M. 

Modifier 78 is used when a patient has an unplanned return to the operating room by the same physician following the initial procedure for a related procedure during the postoperative period. 

Modifier 79 is used when a patient has an unrelated procedure or service by the same physician or another QHC professional during the postoperative period.

Bronchoscopy CPT Code Examples

The following are examples of when a Bronchoscopy CPT code may be billed.

Example 1

A 20-year-old patient is seen for five transbronchial lung biopsies of 2 separate lobes. One biopsy is taken in one lobe and four biopsies in another lobe.

CPT 31628 and 31632 will be used as CPT 31628 describes transbronchial biopsy of one lobe, and 31632 describes additional transbronchial biopsies on other lobes.

Example 2

A patient presents with a 1.5-cm peripheral lung lesion through transendoscopic ultrasound probe guidance, and the lesion is identified. Next, an imaging catheter is introduced via the bronchoscope.

The catheter is directed via multiple segments until the desired sub-segment is specified to reach and image the lesion to confirm the location and specifics. The lesion, which is outside of the visible field of the bronchoscope, is located and described.

The catheter is then removed, and the target access. The catheter is reintroduced to reconfirm position and access to the target. The process is repeated for each additional target lesion.

CPT 31654 will be used as the provider performs bronchoscopy with transendoscopic endobronchial ultrasound.

Example 3

Bronchoscopy and bilateral washings of a patient were done. A complete survey of the airways was achieved. Bilateral washings and bronchial alveolar lavage from the right upper lobe with endobronchial biopsies from the right upper lobe and brushing from the right upper lobe were done successfully endoscopically.”

This procedure is coded with CPT 31625; the procedure is performed as bronchoscopy, with cell washing and endobronchial biopsies from a single site.