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The procedure described by CPT® Code 31649 involves the removal of bronchial valves using either a rigid or flexible bronchoscope, which is a specialized instrument designed for visualizing the airways. Bronchial valves are devices placed within the bronchial passages to manage airflow and treat various pulmonary conditions. However, complications or a lack of patient benefit may necessitate their removal. During the procedure, the bronchoscope is inserted through the patient's nose or mouth and navigated through the oropharynx and trachea, ultimately reaching the mainstem bronchus. Fluoroscopic guidance may be utilized to enhance visualization and ensure accurate placement of the bronchoscope. Once the bronchoscope is positioned in the segmental or subsegmental bronchus where the valve is located, the valve and its surrounding structures are carefully examined. The central rod of the valve is then grasped with biopsy forceps, which facilitates the collapse of the valve, allowing for its removal. After the valve is extracted, the bronchoscope is reinserted to inspect the bronchial area for any signs of injury or complications. Finally, the bronchoscope is withdrawn, and a thorough examination of the bronchi, trachea, and oropharynx is conducted to ensure the integrity of these structures. This code is specifically used for the removal of bronchial valves from each additional lobe, following the primary procedure, which is coded separately.
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The procedure associated with CPT® Code 31649 is indicated for patients who have bronchial valves that may be causing complications or are no longer providing a benefit to the patient. The specific indications for performing this procedure include:
The procedure for the removal of bronchial valves using CPT® Code 31649 involves several critical steps, which are detailed as follows:
Post-procedure care following the removal of bronchial valves using CPT® Code 31649 typically involves monitoring the patient for any immediate complications, such as bleeding or respiratory distress. Patients may be observed in a recovery area until they are stable and can be safely discharged. Instructions regarding follow-up care, potential symptoms to watch for, and any necessary follow-up appointments should be provided to the patient. Additionally, the healthcare provider may recommend further evaluation or treatment based on the findings during the procedure and the patient's overall condition.
| Short Descr | BRONCHIAL VALVE REMOV ADDL | Medium Descr | BRNCHSC REMOVAL BRONCHIAL VALVE EA ADDL | Long Descr | Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of bronchial valve(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 | T-Packaged Codes | 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) | P8F - Endoscopy - bronchoscopy | MUE | 2 | CCS Clinical Classification | 41 - Other non-OR therapeutic procedures on respiratory system |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 31648 | MPFS Status: Active Code APC J1 ASC G2 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of bronchial valve(s), initial lobe |
| 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). | 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.) | 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 | 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 |
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| 2017-01-01 | Changed | Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| 2013-01-01 | Added | Short and medium descriptions changed per AMA 2013 corrections document. |
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