How To Use CPT Code 31651

CPT 31651 describes the procedure for bronchoscopy with balloon occlusion, assessment of air leak, airway sizing, and insertion of bronchial valve(s) in an additional lobe of the lung. 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 31651?

CPT 31651 is a specific code used to describe a procedure called bronchoscopy with balloon occlusion, assessment of air leak, airway sizing, and insertion of bronchial valve(s) in an additional lobe of the lung. This procedure is performed by a healthcare provider to assess the extent of air leakage and size of the bronchial airway involved. It involves the placement of a valve in the bronchus of an additional lobe of the lung, following the placement of a bronchial valve in an initial lobe in the same session. The procedure is done using bronchoscopic visualization.

2. Official Description

The official description of CPT code 31651 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), each additional lobe (List separately in addition to code for primary procedure[s]).’

3. Procedure

1. In this procedure, the healthcare provider assesses the extent of air leakage and size of the bronchial airway involved.
2. The provider places a valve in the bronchus of an additional lobe of the lung, subsequent to the placement of the bronchial valve in an initial lobe in the same session.
3. Fluoroscopic guidance, or live X-ray, is used during the procedure to assist the provider.
4. The provider introduces a balloon catheter in the additional lobe and pushes it to the site of air leakage. The balloon may be inflated to stop the air leak.
5. A calibrating balloon is introduced at the site of the affected area to measure the size of the airway and select the exact size of the valve.
6. The provider places the additional valve with the help of an appropriate guidance instrument.
7. The provider may repeat the service in the same lobe if necessary.
8. The correct placement of the valve is confirmed, and the bronchoscope is slowly removed.

4. Qualifying circumstances

This procedure is performed on patients with lung diseases such as emphysema, atelectasis, or other conditions that cause air leakages. It is typically done when the initial lobe has already had a bronchial valve placed, and the provider needs to place a valve in an additional lobe. The procedure requires bronchoscopic visualization and may involve the use of fluoroscopic guidance.

5. When to use CPT code 31651

CPT code 31651 should be used when the healthcare provider performs bronchoscopy with balloon occlusion, assessment of air leak, airway sizing, and insertion of bronchial valve(s) in an additional lobe of the lung. It is important to note that this code should only be reported when the procedure is performed in addition to a primary procedure code, such as 31647.

6. Documentation requirements

To support a claim for CPT code 31651, the healthcare provider must document the following information:

• Indication for the procedure and the need for bronchial valve placement in an additional lobe
• Details of the procedure, including the use of balloon occlusion, assessment of air leak, airway sizing, and insertion of the bronchial valve(s)
• Date and duration of the procedure
• Specific lobes involved and the number of valves placed
• Confirmation of correct valve placement
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 31651, it is important to ensure that the procedure is performed in addition to a primary procedure code, such as 31647. Payers may not reimburse for this add-on code if it is reported without a primary procedure code. It is also important to count the lobes, not the valves, to determine proper coding. Do not report this code for an additional bronchial valve removed from the initial lobe.

8. Historical information

CPT code 31651 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 healthcare provider performs bronchoscopy with balloon occlusion, assessment of air leak, airway sizing, and insertion of bronchial valve(s) in an additional lobe of the lung following the placement of a bronchial valve in an initial lobe in the same session.
2. During the procedure, the provider uses fluoroscopic guidance to assist in the placement of the valve in the additional lobe.