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The procedure described by CPT® Code 31641 involves the use of a bronchoscope, which can be either rigid or flexible, to perform an examination and treatment of the airways. The bronchoscope is inserted through the nose or mouth and advanced into the oropharynx, allowing for a thorough examination of the vocal cords and the trachea. Fluoroscopic guidance may be utilized during the procedure to enhance visualization. The bronchoscope is then advanced into each mainstem bronchus, where any abnormalities, such as tumors or stenosis, can be identified. The primary purpose of this procedure is to provide therapeutic intervention for tumors or to relieve stenosis using methods other than excision. Various techniques may be employed, including laser therapy, cryotherapy, electrocautery, or argon plasma coagulation (APC), each of which has its own specific approach to destroying the tumor or relieving the obstruction. This procedure is critical for patients with airway obstructions or tumors, as it allows for direct intervention within the bronchial passages, improving airflow and potentially alleviating symptoms associated with these conditions.
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The procedure described by CPT® Code 31641 is indicated for the following conditions:
The procedure begins with the insertion of a bronchoscope, which can be either rigid or flexible, through the patient's nose or mouth. The bronchoscope is carefully advanced into the oropharynx, where an initial examination is conducted. Following this, the vocal cords are visualized and assessed for any abnormalities. The bronchoscope is then further advanced into the trachea, allowing for a detailed examination of the tracheal structure. After assessing the trachea, the bronchoscope is advanced into each mainstem bronchus, where any abnormalities, such as tumors or signs of stenosis, are noted. If a rigid bronchoscope is utilized, a telescope or flexible bronchoscope may be inserted through it to visualize the distal segments of each mainstem bronchus more effectively. Once the tumor or stenosis is identified, a suction catheter and the appropriate therapeutic device, such as a laser fiber, quartz fiber for photodynamic therapy, cryotherapy apparatus, electrocautery device, or argon plasma coagulation (APC) device, are introduced through the bronchoscope. The specific technique employed will depend on the device used; for instance, if laser therapy is chosen, the laser is activated to destroy the lesion while continuous suction is applied to remove debris. In the case of cryotherapy, the lesion is subjected to repetitive freeze/thaw cycles to achieve destruction. If electrocautery is utilized, direct contact is made with the lesion using thermal probes or forceps to apply heat and destroy the tissue. APC, which is another thermal destruction method, does not require direct contact, as argon plasma is used to conduct electric current, creating an arc that generates heat to destroy the lesion. Lastly, if photodynamic therapy is indicated, a photosensitizer is administered intravenously, and a light source is delivered via a quartz fiber through the bronchoscope to activate the treatment.
Post-procedure care following the bronchoscopy with tumor destruction or stenosis relief typically involves monitoring the patient for any immediate complications, such as bleeding or respiratory distress. Patients may be observed for a short period to ensure stable vital signs and adequate oxygenation. Depending on the extent of the procedure and the patient's overall condition, they may be discharged the same day or kept for further observation. Patients are usually advised to avoid strenuous activities and to follow up with their healthcare provider for any necessary additional treatments or evaluations. It is also important for patients to report any unusual symptoms, such as increased coughing, difficulty breathing, or fever, to their healthcare provider promptly.
| Short Descr | BRONCHOSCOPY TREAT BLOCKAGE | Medium Descr | BRNCHSC W/DSTRJ TUM RELIEF STENOSIS OTH/THN EXC | Long Descr | Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with destruction of tumor or relief of stenosis by any method other than excision (eg, laser therapy, cryotherapy) | 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 | 42 - Other OR therapeutic procedures on respiratory system |
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]) | 96570 | Addon Code MPFS Status: Active Code APC N PUB 100 CPT Assistant Article Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); first 30 minutes (List separately in addition to code for endoscopy or bronchoscopy procedures of lung and gastrointestinal tract) | 96571 | Addon Code MPFS Status: Active Code APC N PUB 100 CPT Assistant Article Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); each additional 15 minutes (List separately in addition to code for endoscopy or bronchoscopy procedures of lung and gastrointestinal tract) |
| GC | This service has been performed in part by a resident under the direction of a teaching physician | 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). | 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) | 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. | 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.) | 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). | 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 | CR | Catastrophe/disaster related | 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 | 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 |
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| 2011-01-01 | Changed | Short description changed. |
| 2010-01-01 | Changed | Code description changed. |
| 2008-01-01 | Changed | Code description changed. |
| 2002-01-01 | Changed | Code description changed. |
| 2001-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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