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A bronchoscopy, whether performed using a rigid or flexible instrument, is a medical procedure that allows for direct visualization of the airways, including the trachea and bronchi. During this procedure, a bronchoscope is inserted through the patient's nose or mouth and advanced into the oropharynx, which is the part of the throat located behind the mouth. Fluoroscopic guidance may be utilized to enhance the visualization of the airways as the bronchoscope is maneuvered. This guidance is particularly useful in assessing the anatomy and identifying any abnormalities within the airways. The examination typically includes the oropharynx, vocal cords, and trachea, with a focus on the mainstem bronchus, which branches into the lungs. In cases where a rigid bronchoscope is employed, a telescope or flexible bronchoscope can be introduced through the rigid device to provide a clearer view of the distal segments of the mainstem bronchus. This is crucial for identifying the precise location of any air leaks, which can occur due to various medical conditions. Once the site of the air leak is identified, a balloon catheter is introduced and inflated at the leak site to occlude it. Following this, closure of the air leak may be attempted using various occlusive substances, such as fibrin glue, gelfoam, silicone plugs, or other adhesives. After the procedure, the bronchoscope is carefully withdrawn, allowing for a more thorough examination of the bronchus, trachea, vocal cords, and oropharynx during the withdrawal process. This comprehensive approach ensures that any potential issues within the airways are adequately assessed and addressed.
© Copyright 2026 Coding Ahead. All rights reserved.
The bronchoscopy procedure described by CPT® Code 31634 is indicated for various clinical scenarios where assessment and intervention in the airways are necessary. The following conditions may warrant the performance of this procedure:
The procedure begins with the insertion of a bronchoscope, which can be either rigid or flexible, through the patient's nose or mouth and into the oropharynx. The physician may utilize fluoroscopic guidance to enhance visualization of the airways as the bronchoscope is advanced. This guidance is particularly beneficial for accurately navigating the anatomy of the trachea and bronchi. Once the bronchoscope reaches the mainstem bronchus, the physician conducts a thorough examination of the airways, including the oropharynx, vocal cords, and trachea. If a rigid bronchoscope is utilized, a telescope or flexible bronchoscope may be inserted through it to visualize the distal segments of the mainstem bronchus more effectively. During this examination, the physician identifies the site of any air leak present. Following the identification of the leak, a balloon catheter is introduced into the bronchial passage. The balloon is then inflated at the site of the air leak to occlude it, effectively preventing air from escaping. After the occlusion is achieved, the physician may attempt to close the air leak using various occlusive substances, such as fibrin glue, gelfoam, silicone plugs, or other adhesives. These substances are applied to ensure that the leak is sealed adequately. Once the procedure is completed, the bronchoscope is carefully withdrawn, allowing for a final examination of the bronchus, trachea, vocal cords, and oropharynx as the instrument is removed. This thorough approach ensures that any abnormalities are addressed and that the airways are adequately assessed.
After the bronchoscopy procedure is completed, patients may require monitoring for any immediate complications, such as bleeding or respiratory distress. It is essential to observe the patient for signs of airway obstruction or adverse reactions to the occlusive substances used during the procedure. Patients may also be advised to rest and avoid strenuous activities for a specified period following the procedure. The healthcare provider will typically provide instructions regarding follow-up care, including any necessary imaging studies or additional evaluations to ensure the effectiveness of the intervention and to monitor for any recurrence of air leaks or other complications.
| Short Descr | BRONCH W/BALLOON OCCLUSION | Medium Descr | BRONCHOSCOPY BALLOON OCCLUSION | Long Descr | Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, with assessment of air leak, with administration of occlusive substance (eg, fibrin glue), if performed | 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) | 2 - Payment restriction for assistants at surgery does not apply 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 | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P8I - Endoscopy - other | MUE | 1 | CCS Clinical Classification | 42 - Other OR therapeutic procedures on respiratory system |
| 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). | 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. | 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. | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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 | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2017-01-01 | Changed | Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| 2013-01-01 | Changed | Guideline information changed. |
| 2011-01-01 | Added | Added |
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