How To Use CPT Code 31640

CPT 31640 describes the procedure of bronchoscopy, which involves the examination of the airways using a flexible or rigid tube called a bronchoscope. 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 31640?

CPT 31640 is used to describe the procedure of bronchoscopy, which allows the provider to visually examine the airways using a flexible or rigid tube called a bronchoscope. This procedure may or may not involve the use of fluoroscopic guidance. During the bronchoscopy, the provider may also perform an excision of a tumor present in the airways.

2. Official Description

The official description of CPT code 31640 is: ‘Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with excision of tumor.’

3. Procedure

1. The provider begins by inserting a flexible or rigid bronchoscope through the nose or mouth of the patient.
2. Once the bronchoscope is in place, the provider moves it down into the throat and advances it to the airways of the lung.
3. Using the eyepiece, the provider examines the mucus lining or covering of the airways, looking for any abnormalities or tumors.
4. If a tumor is present, the provider introduces an excising instrument, such as forceps, through the channel in the bronchoscope and performs an excision of the tumor.
5. Fluoroscopic guidance may be used during the procedure, where the provider injects a dye and uses X-ray imaging to guide the passage of the bronchoscope.
6. Once the procedure is complete, the provider removes the bronchoscope and instruments and monitors the patient’s vital signs.

4. Qualifying circumstances

CPT 31640 is performed on patients who require a bronchoscopy with excision of a tumor in the airways. The procedure can be performed using either a flexible or rigid bronchoscope, and fluoroscopic guidance may be used if necessary.

5. When to use CPT code 31640

CPT code 31640 should be used when the provider performs a bronchoscopy with excision of a tumor in the airways. It is important to note that this code should only be used when the excision of the tumor is the primary focus of the procedure.

6. Documentation requirements

To support a claim for CPT 31640, the provider must document the following information:

• Patient’s diagnosis and the need for the bronchoscopy with excision of the tumor
• Details of the procedure, including whether a flexible or rigid bronchoscope was used and if fluoroscopic guidance was utilized
• Date and duration of the procedure
• Description of the tumor excision, including the location and size of the tumor
• Any complications or additional procedures performed
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 31640, ensure that the procedure performed includes both the bronchoscopy and the excision of the tumor. It is important to use the appropriate code based on whether a flexible or rigid bronchoscope was used and if fluoroscopic guidance was utilized. Additionally, be aware of any specific payer guidelines or modifiers that may be required for accurate billing.

8. Historical information

CPT 31640 was added to the Current Procedural Terminology system on January 1, 1990. Since its addition, there have been several changes to the code, including updates to the description and inclusion of fluoroscopic guidance.

9. Examples

1. A provider performs a bronchoscopy with excision of a tumor in the airways using a flexible bronchoscope.
2. During a bronchoscopy procedure, the provider utilizes fluoroscopic guidance and performs an excision of a tumor in the airways using a rigid bronchoscope.
3. A patient undergoes a bronchoscopy with excision of a tumor in the airways, and the provider uses both a flexible and rigid bronchoscope during the procedure.
4. Using a flexible bronchoscope, the provider performs a bronchoscopy with excision of a tumor in the airways and utilizes fluoroscopic guidance.
5. A provider performs a bronchoscopy with excision of a tumor in the airways using a rigid bronchoscope and does not require fluoroscopic guidance.
6. During a bronchoscopy procedure, the provider utilizes fluoroscopic guidance and performs an excision of a tumor in the airways using both a flexible and rigid bronchoscope.
7. A patient undergoes a bronchoscopy with excision of a tumor in the airways, and the provider uses a flexible bronchoscope without fluoroscopic guidance.
8. Using a rigid bronchoscope, the provider performs a bronchoscopy with excision of a tumor in the airways and does not require fluoroscopic guidance.
9. A provider performs a bronchoscopy with excision of a tumor in the airways using a flexible bronchoscope and utilizes fluoroscopic guidance.
10. During a bronchoscopy procedure, the provider utilizes both a flexible and rigid bronchoscope and performs an excision of a tumor in the airways without fluoroscopic guidance.