How To Use CPT Code 31632

CPT 31632 describes the procedure of obtaining transbronchial lung biopsies from an additional lobe of the lung using a rigid or flexible bronchoscope, with or without fluoroscopic guidance. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 31632?

CPT 31632 is used to describe the procedure in which a healthcare provider uses a rigid or flexible bronchoscope to obtain transbronchial lung biopsies from an additional lobe of the lung. This procedure may involve the use of fluoroscopic guidance to assist the provider in obtaining the biopsies accurately.

2. Official Description

The official description of CPT code 31632 is: ‘Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), each additional lobe (List separately in addition to code for primary procedure).’ This code should be used in conjunction with code 31628.

3. Procedure

1. After appropriate preparation and anesthesia, the healthcare provider advances the bronchoscope to another lobe of the lung.
2. The provider examines the mucus lining or covering of the airways in the selected lobe to identify any abnormalities.
3. Using an instrument like tiny forceps, the provider takes transbronchial lung biopsies from the selected lobe.
4. The provider may take single or multiple biopsies and sends them for further investigation.
5. Fluoroscopic guidance may be used during the procedure to ensure accurate placement of the bronchoscope and biopsy instrument.
6. Once the biopsies are obtained, the provider removes the bronchoscope to complete the procedure.

4. Qualifying circumstances

CPT 31632 is performed when a healthcare provider needs to obtain transbronchial lung biopsies from an additional lobe of the lung following the biopsy of an initial lobe. This procedure is typically performed on patients who require further investigation of lung abnormalities or suspected lung diseases. The use of fluoroscopic guidance may be necessary to ensure accurate biopsy placement.

5. When to use CPT code 31632

CPT code 31632 should be used when a healthcare provider performs transbronchial lung biopsies from an additional lobe of the lung using a rigid or flexible bronchoscope, with or without fluoroscopic guidance. This code should be reported in addition to the primary procedure code, which is typically code 31628 for the initial lobe biopsy.

6. Documentation requirements

To support a claim for CPT 31632, the healthcare provider must document the following information:

• Indication for the procedure and the need for transbronchial lung biopsies
• Details of the bronchoscope used (rigid or flexible) and whether fluoroscopic guidance was utilized
• Specific lobe(s) from which the biopsies were obtained
• Number of biopsies taken
• Any complications or adverse events that occurred during the procedure
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 31632, ensure that the procedure was performed using a rigid or flexible bronchoscope, with or without fluoroscopic guidance. This code should be reported in addition to the primary procedure code (typically 31628). It is important to note that CPT 31632 is an add-on code, so it should not be reported without an appropriate primary code.

8. Historical information

CPT 31632 was added to the Current Procedural Terminology system on January 1, 2004. On January 1, 2010, the code description was changed to include the phrase ‘with or without fluoroscopic guidance.’

9. Examples

1. A pulmonologist performing transbronchial lung biopsies from an additional lobe of the lung using a flexible bronchoscope, with fluoroscopic guidance.
2. A thoracic surgeon obtaining transbronchial lung biopsies from an additional lobe of the lung using a rigid bronchoscope, without fluoroscopic guidance.
3. An interventional radiologist performing transbronchial lung biopsies from an additional lobe of the lung using a flexible bronchoscope, with fluoroscopic guidance.
4. A respiratory therapist assisting a pulmonologist in obtaining transbronchial lung biopsies from an additional lobe of the lung using a flexible bronchoscope, with fluoroscopic guidance.
5. An oncologist performing transbronchial lung biopsies from an additional lobe of the lung using a rigid bronchoscope, without fluoroscopic guidance.
6. A pulmonologist obtaining transbronchial lung biopsies from an additional lobe of the lung using a flexible bronchoscope, with fluoroscopic guidance.
7. A thoracic surgeon performing transbronchial lung biopsies from an additional lobe of the lung using a rigid bronchoscope, without fluoroscopic guidance.
8. An interventional radiologist assisting a pulmonologist in obtaining transbronchial lung biopsies from an additional lobe of the lung using a flexible bronchoscope, with fluoroscopic guidance.