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Official Description

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of foreign body

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

A bronchoscopy, as described by CPT® Code 31635, is a medical procedure that involves the insertion of a bronchoscope, which can be either rigid or flexible, through the patient's nose or mouth. This instrument is advanced into the oropharynx, allowing for a thorough examination of the airway structures. The procedure may include fluoroscopic guidance, which utilizes real-time imaging to assist in navigating the bronchoscope and ensuring accurate placement. During the bronchoscopy, the physician examines the oropharynx and visualizes the vocal cords, which are critical for assessing airway patency and function. The bronchoscope is then advanced into the trachea, where the physician can inspect the tracheal walls and any potential obstructions. Following this, the bronchoscope is further advanced into each mainstem bronchus, allowing for a detailed examination of the bronchial passages. If a rigid bronchoscope is utilized, a telescope or flexible bronchoscope may be inserted through it to enhance visualization of the distal segments of the mainstem bronchi. The primary objective of this procedure is to locate and remove any foreign body that may be obstructing the airway. Once the foreign body is identified, specialized extraction forceps are employed to grasp and remove the object. After the extraction, the bronchus is re-examined to ensure that no remnants of the foreign body remain, thereby confirming the success of the procedure and the restoration of airway integrity.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 31635 is indicated for the removal of foreign bodies from the airway. This may be necessary in cases where a patient presents with symptoms such as:

  • Choking A sudden inability to breathe or speak due to an obstruction in the airway.
  • Respiratory distress Difficulty in breathing that may be caused by a foreign object blocking the airway.
  • Coughing Persistent coughing that may indicate the presence of a foreign body in the trachea or bronchi.
  • Wheezing A high-pitched sound during breathing, which may suggest airway obstruction.
  • Inability to expectorate Difficulty in coughing up secretions, which may be exacerbated by a foreign body.

2. Procedure

The procedure for bronchoscopy with foreign body removal involves several critical steps, which are outlined as follows:

  • Step 1: Preparation The patient is positioned appropriately, and sedation may be administered to ensure comfort during the procedure. The physician prepares the bronchoscope and any necessary instruments for foreign body removal.
  • Step 2: 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 preliminary examination of the airway structures.
  • Step 3: Examination of the Oropharynx and Vocal Cords The physician examines the oropharynx and visualizes the vocal cords to assess for any abnormalities or obstructions that may be present.
  • Step 4: Advancement into the Trachea The bronchoscope is then advanced into the trachea, where the physician inspects the tracheal walls and identifies any potential foreign bodies or obstructions.
  • Step 5: Examination of the Mainstem Bronchi The bronchoscope is further advanced into each mainstem bronchus, allowing for a detailed examination of the bronchial passages. Any abnormalities are noted during this inspection.
  • Step 6: Visualization of the Foreign Body Once the foreign body is located, the physician prepares to extract it using specialized instruments.
  • Step 7: Extraction of the Foreign Body Extraction forceps are advanced through the bronchoscope to grasp the foreign body. The physician carefully removes the object from the airway.
  • Step 8: Re-examination of the Bronchus After the foreign body has been extracted, the bronchus is re-examined to ensure that all remnants of the foreign body have been removed, confirming the success of the procedure.

3. Post-Procedure

Post-procedure care following bronchoscopy with foreign body removal includes monitoring the patient for any immediate complications, such as bleeding or respiratory distress. The patient may be observed in a recovery area until the effects of sedation have worn off. Instructions regarding activity restrictions, signs of complications to watch for, and follow-up appointments should be provided to the patient. It is essential to ensure that the airway is clear and that the patient can breathe comfortably before discharge.

Short Descr BRONCHOSCOPY W/FB REMOVAL
Medium Descr BRONCHOSCOPY W/REMOVAL FOREIGN BODY
Long Descr Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of foreign body
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 229 - Nonoperative removal of foreign body

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])
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
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.
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.
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.
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.)
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
CR Catastrophe/disaster related
FS Split (or shared) evaluation and management visit
FT Unrelated evaluation and management (e/m) visit on the same day as another e/m visit or during a global procedure (preoperative, postoperative period, or on the same day as the procedure, as applicable). (report when an e/m visit is furnished within the global period but is unrelated, or when one or more additional e/m visits furnished on the same day are unrelated)
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)
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
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
RT Right side (used to identify procedures performed on the right side of the body)
SG Ambulatory surgical center (asc) facility service
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
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.
2013-01-01 Changed Guideline information changed.
2011-01-01 Changed Guideline information 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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