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Official Description

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

A bronchoscopy is a medical procedure that involves the insertion of a bronchoscope, which can be either rigid or flexible, through the nose or mouth and into the respiratory tract. This procedure allows for direct visualization of the airways, including the trachea and bronchi, to assess for any abnormalities. Fluoroscopic guidance may be utilized during the procedure to enhance the visualization of the structures being examined. The bronchoscope is advanced through the oropharynx, where the vocal cords are also visualized. Following this, the bronchoscope is further advanced into the trachea and into each mainstem bronchus, allowing for a thorough examination of the airways. If a rigid bronchoscope is employed, a telescope or flexible bronchoscope can be inserted through it to provide a clearer view of the distal segments of the bronchi. During the procedure, transbronchial biopsy forceps are used to obtain tissue samples from the outer regions of the lung, specifically from a single lobe. This procedure is essential for diagnosing various lung conditions, as it enables the collection of tissue samples for further analysis.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The bronchoscopy procedure with transbronchial lung biopsy is indicated for various clinical scenarios where lung tissue sampling is necessary. The following conditions may warrant this procedure:

  • Suspicion of Lung Cancer The procedure is often performed when there is a clinical suspicion of malignancy in the lung tissue, allowing for histological examination of suspicious lesions.
  • Interstitial Lung Disease In cases of unexplained interstitial lung disease, a biopsy may be necessary to determine the underlying cause and guide treatment.
  • Pneumonia or Infection When there is a need to identify the causative organism in cases of pneumonia or other pulmonary infections, a biopsy can provide valuable information.
  • Unexplained Pulmonary Nodules The procedure is indicated for the evaluation of solitary pulmonary nodules that require further investigation to rule out malignancy.

2. Procedure

The bronchoscopy procedure with transbronchial lung biopsy involves several key steps to ensure effective tissue sampling and examination.

  • Step 1: Preparation and Anesthesia The patient is prepared for the procedure, which may include the administration of local anesthesia to minimize discomfort. Sedation may also be provided to help the patient relax during the procedure.
  • Step 2: Insertion of the Bronchoscope A bronchoscope, either rigid or flexible, is inserted through the patient's nose or mouth and advanced into the oropharynx. The oropharynx is examined, and the vocal cords are visualized to ensure there are no obstructions or abnormalities.
  • Step 3: Advancement into the Trachea and Bronchi The bronchoscope is then carefully advanced into the trachea, where it is examined for any irregularities. The scope is further advanced into each mainstem bronchus, allowing for a comprehensive evaluation of the airways.
  • Step 4: Biopsy Procedure If abnormalities are noted, tiny transbronchial biopsy forceps are passed through the bronchoscope into the smaller bronchi. Tissue samples are obtained from the outer part of the lung, specifically from a single lobe, ensuring that adequate samples are collected for diagnostic purposes.

3. Post-Procedure

After the bronchoscopy with transbronchial lung biopsy, patients are typically monitored for any immediate complications, such as bleeding or respiratory distress. It is common for patients to experience a sore throat or mild discomfort following the procedure. Recovery time may vary, but patients are usually advised to rest and avoid strenuous activities for a short period. Follow-up appointments may be scheduled to discuss biopsy results and any further management based on the findings.

Short Descr BRONCHOSCOPY/LUNG BX EACH
Medium Descr BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE
Long Descr Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 3 - Special payment adjustment rules for multiple endoscopic procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Endoscopic Base Code 31622  Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P8F - Endoscopy - bronchoscopy
MUE 1
CCS Clinical Classification 37 - Diagnostic bronchoscopy and biopsy of bronchus

This is a primary code that can be used with these additional add-on codes.

31627 Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Illustration for Code Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with computer-assisted, image-guided navigation (List separately in addition to code for primary procedure[s])
31632 Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Illustration for Code Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), each additional lobe (List separately in addition to code for primary procedure)
31654 Addon Code MPFS Status: Active Code APC N ASC N1 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transendoscopic endobronchial ultrasound (EBUS) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion(s) (List separately in addition to code for primary procedure[s])
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
GC This service has been performed in part by a resident under the direction of a teaching physician
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
RT Right side (used to identify procedures performed on the right side of the body)
LT Left side (used to identify procedures performed on the left side of the body)
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
CR Catastrophe/disaster related
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
95 Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system.
AG Primary physician
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
KX Requirements specified in the medical policy have been met
PO Excepted service provided at an off-campus, outpatient, provider-based department of a hospital
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
SG Ambulatory surgical center (asc) facility service
X3 Episodic/broad services: for reporting services by clinicians who have broad responsibility for the comprehensive needs of the patient that is limited to a defined period and circumstance such as a hospitalization; reporting clinician service examples include but are not limited to the hospitalist's services rendered providing comprehensive and general care to a patient while admitted to the hospital
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
Date
Action
Notes
2017-01-01 Changed Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category.
2011-01-01 Changed Short description changed.
2010-01-01 Changed Code description changed.
2004-01-01 Changed Code description changed.
2001-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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