How To Use CPT Code 31638

CPT 31638 describes the procedure of revising a tracheal or bronchial stent that was previously inserted, using either rigid or flexible bronchoscopy 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 31638?

CPT 31638 is used to describe the procedure of revising a tracheal or bronchial stent that was previously inserted. This procedure involves the use of either rigid or flexible bronchoscopy, with or without fluoroscopic guidance. The provider may also perform tracheal or bronchial dilation if necessary before revising the stent.

2. Official Description

The official description of CPT code 31638 is: ‘Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with revision of tracheal or bronchial stent inserted at previous session (includes tracheal/bronchial dilation as required)’

3. Procedure

1. The provider begins by performing either rigid or flexible bronchoscopy to visualize the airways.
2. Using fluoroscopic guidance if necessary, the provider locates the previously inserted tracheal or bronchial stent.
3. If there is a need for revision, the provider may adjust the stent or replace it with a new one.
4. If tracheal or bronchial dilation is required, the provider introduces dilators over a guide wire and dilates the narrowed area.
5. Throughout the procedure, the provider monitors the patient’s vital signs and ensures their safety and comfort.

4. Qualifying circumstances

CPT 31638 is performed when a tracheal or bronchial stent needs to be revised or replaced. This procedure is typically done for patients with airway diseases that require stent placement, such as tracheal or bronchial stenosis. The provider must use either rigid or flexible bronchoscopy, and fluoroscopic guidance may be used if necessary. Tracheal or bronchial dilation may also be performed if required before revising the stent.

5. When to use CPT code 31638

CPT code 31638 should be used when a provider performs the procedure of revising a tracheal or bronchial stent that was previously inserted. This code is appropriate when either rigid or flexible bronchoscopy is used, with or without fluoroscopic guidance. Tracheal or bronchial dilation may also be performed if necessary before revising the stent.

6. Documentation requirements

To support a claim for CPT 31638, the provider must document the following information:

• Reason for the revision of the tracheal or bronchial stent
• Type of bronchoscopy used (rigid or flexible)
• Use of fluoroscopic guidance, if applicable
• Details of the revision procedure, including any adjustments or replacement of the stent
• Documentation of tracheal or bronchial dilation, if performed
• Monitoring of vital signs and patient safety during the procedure

7. Billing guidelines

When billing for CPT 31638, ensure that the procedure involves the revision of a tracheal or bronchial stent that was previously inserted. The provider must use either rigid or flexible bronchoscopy, with or without fluoroscopic guidance. It is important to follow the specific documentation requirements and guidelines provided by the payer to ensure accurate billing and reimbursement.

8. Historical information

CPT 31638 was added to the Current Procedural Terminology system on January 1, 2005. On January 1, 2010, the code description was slightly modified to include tracheal/bronchial dilation as required.

9. Examples

1. A patient who previously had a tracheal stent inserted undergoes a revision procedure using flexible bronchoscopy with fluoroscopic guidance.
2. A provider performs rigid bronchoscopy to revise a bronchial stent that was previously inserted in a patient with bronchial stenosis.
3. Using flexible bronchoscopy, a provider adjusts a tracheal stent that was previously placed in a patient with tracheal stenosis.
4. A patient with a history of bronchial stent placement undergoes a revision procedure using rigid bronchoscopy without fluoroscopic guidance.
5. A provider performs flexible bronchoscopy with tracheal dilation and revision of a tracheal stent in a patient with tracheal stenosis.
6. Using rigid bronchoscopy, a provider replaces a bronchial stent that was previously inserted in a patient with bronchial stenosis.
7. A patient with a history of tracheal stent placement undergoes a revision procedure using flexible bronchoscopy without fluoroscopic guidance.
8. A provider performs rigid bronchoscopy with bronchial dilation and revision of a bronchial stent in a patient with bronchial stenosis.
9. Using flexible bronchoscopy, a provider adjusts a tracheal stent that was previously placed in a patient with tracheal stenosis.
10. A patient who previously had a bronchial stent inserted undergoes a revision procedure using rigid bronchoscopy with fluoroscopic guidance.