How To Use CPT Code 31635

CPT 31635 describes the procedure of bronchoscopy, which involves the insertion of a flexible or rigid tube called a bronchoscope into the airways to visually examine them. 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 31635?

CPT 31635 is a code used to describe the procedure of bronchoscopy. During this procedure, a healthcare provider inserts a bronchoscope, which can be either flexible or rigid, into the airways to visually examine them. This allows the provider to assess the condition of the mucus lining or covering of the airways and identify any abnormalities or foreign bodies that may be present.

2. Official Description

The official description of CPT code 31635 is: ‘Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of foreign body.’ This code specifically includes the use of fluoroscopic guidance, if necessary, during the bronchoscopy procedure. It is important to note that this code is not applicable for the removal of implanted bronchial valves, which has its own specific codes (31648-31649).

3. Procedure

1. The healthcare provider prepares the patient for the bronchoscopy procedure, ensuring that they are appropriately prepped and anesthetized.
2. The provider then inserts the bronchoscope through the patient’s nose or mouth and advances it down into the throat.
3. Using the eyepiece, the provider examines the mucus lining or covering of the airways, looking for any abnormalities or foreign bodies.
4. If a foreign body is identified, the provider uses forceps to remove it from the airways.
5. In some cases, the provider may also use fluoroscopic guidance, which involves injecting a dye and using X-ray imaging to guide the passage of the bronchoscope.
6. Once the procedure is complete, the provider removes the bronchoscope and monitors the patient’s vital signs.

4. Qualifying circumstances

CPT 31635 is applicable when a healthcare provider performs a bronchoscopy procedure with the specific purpose of removing a foreign body from the airways. This code is used for both rigid and flexible bronchoscopies and includes the use of fluoroscopic guidance, if necessary. It is important to note that this code is not applicable for the removal of implanted bronchial valves, which has its own specific codes (31648-31649).

5. When to use CPT code 31635

CPT code 31635 should be used when a healthcare provider performs a bronchoscopy procedure with the specific purpose of removing a foreign body from the airways. This code is not applicable for other bronchoscopy procedures that do not involve the removal of a foreign body. It is important to accurately document the reason for the procedure and ensure that it aligns with the requirements of CPT code 31635.

6. Documentation requirements

To support a claim for CPT code 31635, the healthcare provider must document the following information:

• Reason for the bronchoscopy procedure, specifically the presence of a foreign body in the airways
• Type of bronchoscope used (rigid or flexible)
• Use of fluoroscopic guidance, if applicable
• Description of the foreign body and its removal
• Date and duration of the procedure
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 31635, it is important to ensure that the procedure meets the specific requirements outlined in the code description. This includes the removal of a foreign body from the airways using a bronchoscope, whether it is rigid or flexible. It is also important to accurately document the use of fluoroscopic guidance, if applicable. Additionally, it is crucial to review any specific billing guidelines provided by insurance payers to ensure proper reimbursement.

8. Historical information

CPT code 31635 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 updates in 2001, 2004, and 2010. These changes have refined the code to better reflect the specific procedure of bronchoscopy with removal of a foreign body.

9. Examples

1. A healthcare provider performs a bronchoscopy procedure using a flexible bronchoscope to remove a peanut lodged in a patient’s airway.
2. During a bronchoscopy procedure, a provider uses a rigid bronchoscope to remove a small toy part that a child accidentally inhaled.
3. A patient undergoes a bronchoscopy procedure with fluoroscopic guidance to remove a fish bone stuck in their airway.
4. A healthcare provider performs a bronchoscopy procedure using a flexible bronchoscope to remove a piece of metal that a worker inhaled at a construction site.
5. During a bronchoscopy procedure, a provider uses a rigid bronchoscope to remove a plastic cap that a patient accidentally aspirated.
6. A healthcare provider performs a bronchoscopy procedure using a flexible bronchoscope to remove a button battery that a child swallowed.
7. During a bronchoscopy procedure, a provider uses a rigid bronchoscope to remove a piece of glass that a patient inhaled during a car accident.