How To Use CPT Code 31630

CPT 31630 describes a procedure that involves the use of a bronchoscope, either rigid or flexible, to view the airways during a medical intervention. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 31630?

CPT 31630 is a code used to describe a specific procedure that involves the use of a bronchoscope, either rigid or flexible, to visualize the airways during a medical intervention. This code is used when the provider performs tracheal or bronchial dilation or closed reduction of a fracture using the bronchoscope, with or without fluoroscopic guidance.

2. Official Description

The official description of CPT code 31630 is: ‘Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with tracheal/bronchial dilation or closed reduction of fracture.’

3. Procedure

1. The provider begins by inserting a bronchoscope, either rigid or flexible, through the nose or mouth of the patient.
2. Once the bronchoscope is in place, the provider advances it down into the throat and into the bronchus, the main passageway to the lung.
3. Using the eyepiece of the bronchoscope, the provider examines the mucus lining or covering of the airways, looking for any abnormalities or narrowing.
4. If a narrowing or stenosis is identified, the provider may pass a guide wire through the bronchoscope to the site of the narrowing.
5. At the site of the narrowing, the provider may introduce a balloon over the guide wire and inflate it to open the obstruction or treat the fracture.
6. In some cases, the provider may use fluoroscopic guidance, which involves injecting a dye and using X-ray imaging to guide the passage of the bronchoscope and perform the procedure.
7. Once the procedure is complete, the provider removes the bronchoscope and monitors the patient for vital signs.

4. Qualifying circumstances

CPT 31630 is performed in cases where there is a need for tracheal or bronchial dilation or closed reduction of a fracture. This procedure is typically performed when there is a narrowing or stenosis in the airways that requires dilation or when there is a fracture in the trachea or bronchi that needs to be reduced. The use of a bronchoscope, either rigid or flexible, is necessary to visualize and perform the necessary interventions.

5. When to use CPT code 31630

CPT code 31630 should be used when a provider performs tracheal or bronchial dilation or closed reduction of a fracture using a bronchoscope, either rigid or flexible, with or without fluoroscopic guidance. This code should be reported for each instance of the procedure performed.

6. Documentation requirements

To support a claim for CPT 31630, the provider must document the following information:

• Reason for the procedure, including the presence of a narrowing or stenosis in the airways or a fracture in the trachea or bronchi
• Type of bronchoscope used (rigid or flexible)
• Whether fluoroscopic guidance was used
• Date and duration of the procedure
• Details of the interventions performed, such as tracheal or bronchial dilation or closed reduction of a fracture
• Any complications or adverse events that occurred during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 31630, ensure that the procedure involves the use of a bronchoscope, either rigid or flexible, and includes tracheal or bronchial dilation or closed reduction of a fracture. If fluoroscopic guidance is used, it should be documented as well. There are no specific guidelines regarding reporting CPT 31630 with other codes, but it is important to accurately report all services provided during the procedure.

8. Historical information

CPT 31630 was added to the Current Procedural Terminology system on January 1, 1990. Since its addition, there have been several changes to the code description, including modifications to the wording and the inclusion of fluoroscopic guidance.

9. Examples

1. A provider performs a bronchoscopy with tracheal dilation using a flexible bronchoscope to treat a patient with tracheal stenosis.
2. During a bronchoscopy procedure, a provider uses a rigid bronchoscope to perform closed reduction of a tracheobronchial fracture in a patient who experienced trauma.
3. A patient with a history of recurrent pneumonia undergoes a bronchoscopy with bronchial dilation using a flexible bronchoscope to address bronchial stenosis.
4. A provider performs a bronchoscopy with tracheal dilation and fluoroscopic guidance to treat a patient with tracheal stenosis due to a previous intubation.
5. During a bronchoscopy procedure, a provider uses a rigid bronchoscope to perform closed reduction of a bronchial fracture in a patient who experienced a fall.
6. A patient with a suspected foreign body in the airway undergoes a bronchoscopy with removal of the foreign body using a flexible bronchoscope.
7. A provider performs a bronchoscopy with tracheal dilation and brushings to obtain samples for cytological analysis in a patient with suspected lung cancer.