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Official Description

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), each additional lobe (List separately in addition to code for primary procedure)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 31633 involves the use of a bronchoscope, which can be either rigid or flexible, to perform a detailed examination of the airways. This procedure includes fluoroscopic guidance, which is a type of imaging that allows real-time visualization of the bronchoscope's position within the respiratory tract. The bronchoscope is inserted through the nose or mouth and is advanced into the oropharynx, where the physician can examine the area for any abnormalities. The vocal cords are also visualized during this process. Following this initial examination, the bronchoscope is further advanced into the trachea, allowing for a thorough inspection of the trachea and the mainstem bronchi. If a rigid bronchoscope is utilized, a telescope or a flexible bronchoscope may be inserted through it to enhance visualization of the distal segments of the mainstem bronchi. This is crucial for identifying any lesions or abnormalities that may not be visible with a standard bronchoscope. The procedure also includes the use of a catheter equipped with a flexible needle tip, which is introduced to perform transbronchial needle aspiration (TBNA) biopsy. This technique allows for the collection of tissue samples from the trachea, main stem bronchus, or lobar bronchus. The TBNA needle is carefully maneuvered to the biopsy site, and suction is applied while the needle is agitated to collect cells for biopsy. The procedure is designed to report one or more tissue samples obtained from each additional lobe, following the primary tissue sample taken from the first lobe, which is reported separately. This comprehensive approach ensures that multiple sites can be biopsied during a single session, enhancing diagnostic accuracy and efficiency.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 31633 is indicated for various clinical scenarios where tissue sampling from the lungs is necessary. The following conditions may warrant the use of this procedure:

  • Suspicion of Lung Cancer - When there is a need to obtain tissue samples to confirm or rule out malignancy in the lungs.
  • Interstitial Lung Disease - For patients presenting with unexplained lung disease where biopsy is required to determine the underlying cause.
  • Pneumonia with Suspected Abscess - In cases where there is a need to differentiate between types of pneumonia or to assess for abscess formation.
  • Unexplained Pulmonary Nodules - When nodules are detected on imaging studies and further investigation is needed to ascertain their nature.

2. Procedure

The procedure involves several key steps to ensure effective tissue sampling and examination. Each step is critical for the successful execution of the bronchoscopy and subsequent biopsy.

  • Step 1: Insertion of the Bronchoscope - The bronchoscope, either rigid or flexible, is inserted through the patient's nose or mouth and advanced into the oropharynx. This initial step allows for a thorough examination of the oropharynx and vocal cords.
  • Step 2: Advancement into the Trachea - After examining the oropharynx, the bronchoscope is further advanced into the trachea. This step is crucial for visualizing the trachea and mainstem bronchi for any abnormalities.
  • Step 3: Visualization of the Mainstem Bronchi - The bronchoscope is then advanced into each mainstem bronchus, where the physician can inspect for lesions or other abnormalities. If a rigid bronchoscope is used, a telescope or flexible bronchoscope may be inserted through it to enhance visualization of the distal segments.
  • Step 4: Introduction of the TBNA Needle - A catheter with a flexible needle tip is introduced through the bronchoscope to perform transbronchial needle aspiration (TBNA) biopsy. This step is essential for obtaining tissue samples from the trachea, main stem bronchus, or lobar bronchus.
  • Step 5: Tissue Sampling - The TBNA needle is maneuvered to the biopsy site, and suction is applied while the needle is agitated back and forth across the tissue or lesion. This technique allows for the collection of cells for biopsy.
  • Step 6: Withdrawal of the Catheter - After the tissue samples are obtained, the catheter is withdrawn. This procedure reports one or more tissue samples obtained from each additional lobe following the primary tissue sample taken from the first lobe, which is reported separately.

3. Post-Procedure

Post-procedure care following a bronchoscopy with transbronchial needle aspiration biopsy is essential for patient recovery and monitoring. Patients are typically observed for any immediate complications, such as bleeding or respiratory distress. It is common for patients to experience mild discomfort in the throat or chest following the procedure. Monitoring vital signs and oxygen saturation levels is crucial during the recovery phase. Patients may be advised to refrain from strenuous activities for a short period and to follow up with their healthcare provider for results and further management based on the biopsy findings. Any specific post-procedure instructions should be provided by the physician based on the individual patient's condition and the findings from the procedure.

Short Descr BRONCHOSCOPY/NEEDLE BX ADDL
Medium Descr BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE
Long Descr Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), each additional lobe (List separately in addition to code for primary procedure)
Status Code Active Code
Global Days ZZZ - Code Related to Another Service
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 0 - No payment adjustment rules for multiple 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.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Items and Services Packaged into APC Rates
ASC Payment Indicator Packaged service/item; no separate payment made.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P8F - Endoscopy - bronchoscopy
MUE 2
CCS Clinical Classification 37 - Diagnostic bronchoscopy and biopsy of bronchus

This is an add-on code that must be used in conjunction with one of these primary codes.

31629 MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i)
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.
GC This service has been performed in part by a resident under the direction of a teaching physician
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.
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).
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).
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
CR Catastrophe/disaster related
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
LT Left side (used to identify procedures performed on the left side of the body)
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
RT Right side (used to identify procedures performed on the right side of the body)
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2017-01-01 Changed Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category.
2016-01-01 Changed Moderate (Conscious) Sedation flag added
2010-01-01 Changed Code description changed.
2004-01-01 Added First appearance in code book in 2004.
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