How To Use CPT Code 31634

CPT 31634 describes a specific endoscopy procedure performed on the trachea and bronchi. 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 31634?

CPT 31634 is a code used to describe a bronchoscopy procedure that involves the insertion of a balloon catheter into the lungs. The purpose of this procedure is to assess for air leaks and potentially administer an occlusive substance to fix any leakage permanently. Fluoroscopic guidance may also be used during the procedure to aid the provider.

2. Official Description

The official description of CPT code 31634 is: ‘Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, with assessment of air leak, with administration of occlusive substance (eg, fibrin glue), if performed.’

3. Procedure

1. The provider begins by inserting a bronchoscope through the nose or mouth and advances it down into the throat.
2. The bronchoscope is then guided to the bronchus, the main passageway to the lung.
3. The provider examines the mucus lining or covering of the airways for any abnormalities.
4. A balloon catheter is introduced through the bronchoscope and inflated to occlude the airway.
5. The provider assesses the patient for air leaks, such as from a bronchopleural fistula (BPF), which is an abnormal passageway between a bronchus and the pleural cavity.
6. If an air leak is detected, the provider may administer an occlusive substance, such as glue or sealant, to treat the leak.
7. Fluoroscopic guidance may be used during the procedure to visualize body structures and instruments.
8. Once the procedure is complete, the bronchoscope is removed.

4. Qualifying circumstances

CPT 31634 is typically performed on patients who require assessment and treatment of air leaks in the trachea and bronchi. This procedure may be necessary for patients with conditions such as bronchopleural fistula or other abnormalities in the airways. The use of a balloon catheter and potential administration of an occlusive substance are key qualifying circumstances for this code.

5. When to use CPT code 31634

CPT code 31634 should be used when a provider performs a bronchoscopy procedure that involves balloon occlusion, assessment of air leak, and potential administration of an occlusive substance. It is important to note that this code should not be reported in conjunction with codes 31647 and 31651 during the same session.

6. Documentation requirements

To support a claim for CPT 31634, the provider must document the following information:

• Patient’s diagnosis and the need for the bronchoscopy procedure
• Details of the procedure, including the use of balloon occlusion, assessment of air leak, and administration of an occlusive substance if performed
• Date and duration of the procedure
• Fluoroscopic guidance, if used
• Any complications or adverse events that occurred during the procedure
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 31634, ensure that the procedure meets the specific criteria outlined in the code description. It is important to note that this code should not be reported with codes 31647 and 31651 during the same session. Additionally, consider the use of modifiers if necessary to accurately reflect the circumstances of the procedure.

8. Historical information

CPT 31634 was added to the Current Procedural Terminology system on January 1, 2011. There have been no updates to the code since its addition.

9. Examples

1. A provider performs a bronchoscopy procedure on a patient with a suspected bronchopleural fistula. The provider uses a balloon catheter to occlude the airway, assesses for air leaks, and administers an occlusive substance to treat the leak.
2. During a bronchoscopy procedure, a provider identifies an abnormality in the airways and uses a balloon catheter to occlude the airway for further assessment. No air leaks are detected, and no occlusive substance is administered.
3. A patient with a history of air leaks undergoes a bronchoscopy procedure. The provider uses fluoroscopic guidance to assist in the insertion of the balloon catheter and assesses for air leaks. An occlusive substance is administered to treat a detected leak.
4. During a bronchoscopy procedure, a provider identifies a bronchopleural fistula and uses a balloon catheter to occlude the airway. No air leaks are detected, and no occlusive substance is administered.
5. A patient with a suspected abnormality in the airways undergoes a bronchoscopy procedure. The provider uses fluoroscopic guidance to aid in the insertion of the balloon catheter and assesses for air leaks. No occlusive substance is administered.
6. During a bronchoscopy procedure, a provider identifies an air leak and uses a balloon catheter to occlude the airway. An occlusive substance is administered to treat the leak.
7. A patient with a history of bronchopleural fistula undergoes a bronchoscopy procedure. The provider uses fluoroscopic guidance to assist in the insertion of the balloon catheter and assesses for air leaks. No occlusive substance is administered.