How To Use CPT Code 31647

CPT 31647 describes a specific procedure performed on the trachea and bronchi using a bronchoscope. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 31647?

CPT 31647 involves a procedure performed on the trachea and bronchi using a bronchoscope. It is used to assess the extent of air leakage and the size of the bronchial airway involved. The provider places a valve in the bronchus to control the inflow of air in the lung where elasticity has been lost.

2. Official Description

The official description of CPT code 31647 is: ‘Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), initial lobe.’

3. Procedure

1. The provider administers adequate anesthesia to the patient in the endoscopy suite.
2. A rigid or flexible bronchoscope is inserted through the nose or mouth to examine the patient’s airways for abnormalities.
3. Fluoroscopic guidance, or live X-ray, is used during the procedure.
4. A balloon catheter is introduced and pushed to the site of air leakage, which may be inflated to stop the leakage.
5. A calibrating balloon is introduced to measure the size of the airway and select the appropriate size of the valve.
6. The valve is placed with the help of a guidance instrument.
7. The correct placement of the valve is confirmed, and the bronchoscope is slowly removed.

4. Qualifying circumstances

CPT 31647 is performed on patients with air leakage due to lung diseases such as emphysema or atelectasis. The procedure is done by a provider using a bronchoscope and includes the assessment of air leak, airway sizing, and insertion of bronchial valve(s) in the initial lobe.

5. When to use CPT code 31647

CPT code 31647 should be used when a provider performs a bronchoscopy procedure with balloon occlusion, assessment of air leak, airway sizing, and insertion of bronchial valve(s) in the initial lobe. It is important to ensure that the procedure meets all the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 31647, the provider must document the following information:

• Patient’s diagnosis and indication for the procedure
• Details of the procedure performed, including the use of fluoroscopic guidance and balloon occlusion
• Specific findings during the procedure, such as the extent of air leakage and the size of the airway
• Description of the valve(s) inserted and their placement
• Confirmation of correct valve placement
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 31647, ensure that the procedure meets all the specific criteria outlined in the code description. It is important to report this code only for valve placement in the initial lobe. If the provider places valves in additional lobes, report the service on each lobe using add-on code +31651. Be aware of any additional guidelines or modifiers that may apply based on payer requirements.

8. Historical information

CPT 31647 was added to the Current Procedural Terminology system on January 1, 2013. There have been no updates to the code since its addition.

9. Examples

1. A provider performs a bronchoscopy procedure with balloon occlusion, assessment of air leak, airway sizing, and insertion of bronchial valve(s) in the initial lobe to control air leakage in a patient with emphysema.
2. During a bronchoscopy, a provider uses fluoroscopic guidance to assess air leak and airway sizing, and inserts a bronchial valve in the initial lobe of a patient with atelectasis.
3. A patient with lung disease undergoes a bronchoscopy procedure with balloon occlusion, assessment of air leak, airway sizing, and insertion of bronchial valve(s) in the initial lobe to manage air leakage.
4. A provider performs a bronchoscopy with fluoroscopic guidance, assessing air leak and airway sizing, and inserts a bronchial valve in the initial lobe of a patient with chronic obstructive pulmonary disease (COPD).
5. During a bronchoscopy, a provider uses balloon occlusion, assesses air leak and airway sizing, and inserts a bronchial valve in the initial lobe of a patient with lung disease.
6. A patient with emphysema undergoes a bronchoscopy procedure with fluoroscopic guidance, assessment of air leak, airway sizing, and insertion of bronchial valve(s) in the initial lobe to control air leakage.
7. A provider performs a bronchoscopy with balloon occlusion, assessing air leak and airway sizing, and inserts a bronchial valve in the initial lobe of a patient with atelectasis.
8. During a bronchoscopy, a provider uses fluoroscopic guidance to assess air leak and airway sizing, and inserts a bronchial valve in the initial lobe of a patient with lung disease.
9. A patient with chronic obstructive pulmonary disease (COPD) undergoes a bronchoscopy procedure with balloon occlusion, assessment of air leak, airway sizing, and insertion of bronchial valve(s) in the initial lobe to manage air leakage.