Coding Ahead
CasePilot
Medical Coding Assistant
CaseConsultant
Instant Email Coding Consultant
Case2Code
Search and Code Lookup Tool
CareerCenter
Medical Coding Job Board
Log in Register free account

Need help choosing the right code?

Ask CasePilot about procedures, modifiers, bundling, and coding guidance.

Try CasePilot

Official Description

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), each additional lobe (List separately in addition to code for primary procedure[s])

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Bronchoscopy, as described by CPT® Code 31651, is a medical procedure that involves the examination of the airways using a bronchoscope, which can be either rigid or flexible. This procedure is particularly focused on assessing the airways for size and identifying any air leaks. The bronchoscope is inserted through the mouth and navigated through the oropharynx and trachea, ultimately reaching the right or left mainstem bronchus. Fluoroscopic guidance may be utilized during this process to enhance visualization and accuracy. Once the bronchoscope is positioned in the segmental or subsegmental bronchus of the lobe suspected of containing an air leak, the healthcare provider can visualize and evaluate the structures within the airway. A calibrated balloon catheter is employed for airway sizing, allowing for precise measurement of the airway dimensions. Intermittent balloon occlusion is used to identify the specific airways that are contributing to the air leakage. The balloon catheter is advanced and inflated while monitoring the air leak in a water seal chamber. If a reduction or cessation of the air leak is observed, a delivery catheter is then advanced through the bronchoscope to place a bronchial valve. Following the placement of the valve, the bronchoscope is reinserted into the segmental or subsegmental bronchus to check for any signs of injury. Finally, the bronchoscope is withdrawn, and a thorough examination of the bronchi, trachea, and oropharynx is conducted to ensure comprehensive assessment. It is important to report CPT® Code 31651 for each additional lobe treated after the initial lobe has been addressed, as indicated by the related code 31647.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 31651 is indicated for the following conditions:

  • Assessment of Air Leak This procedure is performed to evaluate the presence and extent of air leaks within the bronchial system, which can occur due to various pulmonary conditions.
  • Airway Sizing It is utilized to measure the size of the airways accurately, which is crucial for determining the appropriate interventions, such as the placement of bronchial valves.
  • Insertion of Bronchial Valve(s) The procedure is indicated when there is a need to insert bronchial valves to manage air leaks effectively and improve patient outcomes.

2. Procedure

The procedure involves several critical steps, each essential for achieving the desired outcomes:

  • Step 1: Insertion of the Bronchoscope The bronchoscope, either rigid or flexible, is inserted through the patient's mouth and advanced into the oropharynx. The provider carefully navigates the bronchoscope through the trachea and into the right or left mainstem bronchus, utilizing fluoroscopic guidance as necessary to ensure accurate placement.
  • Step 2: Advancement into the Affected Lobe Once the bronchoscope is positioned in the mainstem bronchus, it is further advanced into the segmental or subsegmental bronchus of the lobe that is suspected to contain the air leak. This step allows for direct visualization of the airway structures.
  • Step 3: Visualization and Evaluation The healthcare provider visualizes the bronchial structures and evaluates them for any abnormalities or signs of injury. This assessment is crucial for determining the next steps in managing the air leak.
  • Step 4: Airway Sizing A calibrated balloon catheter is introduced to perform airway sizing. This step is vital for accurately measuring the dimensions of the airways, which informs the subsequent interventions.
  • Step 5: Identification of Air Leak The provider identifies the airways leading to the air leakage using intermittent balloon occlusion. This technique helps pinpoint the specific areas that require intervention.
  • Step 6: Balloon Inflation and Monitoring The balloon catheter is advanced and inflated while observing the air leak in a water seal chamber. This monitoring is essential to assess the effectiveness of the occlusion in reducing or stopping the air leak.
  • Step 7: Placement of Bronchial Valve If a reduction or cessation of the air leak is observed, a delivery catheter is advanced through the bronchoscope to place a bronchial valve in the affected airway. This step is critical for managing the air leak and improving respiratory function.
  • Step 8: Final Examination After the valve placement, the bronchoscope is reinserted into the segmental or subsegmental bronchus to examine for any evidence of injury. This thorough examination ensures that any potential complications are identified and addressed.
  • Step 9: Withdrawal and Final Assessment The bronchoscope is then withdrawn, and a comprehensive examination of the bronchi, trachea, and oropharynx is conducted to ensure that all areas have been adequately assessed and treated.

3. Post-Procedure

Post-procedure care following the bronchoscopy with balloon occlusion includes monitoring the patient for any immediate complications, such as respiratory distress or bleeding. Patients may be observed for signs of improvement in respiratory function, particularly in relation to the air leak that was addressed. Follow-up imaging or assessments may be necessary to evaluate the effectiveness of the bronchial valve placement and to ensure that no further interventions are required. Additionally, healthcare providers should provide patients with instructions regarding any activity restrictions or signs of complications to watch for as they recover.

Short Descr BRONCHIAL VALVE ADDL INSERT
Medium Descr BRNCHSC OCCLUSION&INSERT BRONCH VALVE ADDL LOBE
Long Descr Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), each additional lobe (List separately in addition to code for primary procedure[s])
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 3
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.

31647 MPFS Status: Active Code APC J1 ASC J8 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), initial lobe
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).
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.)
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.)
GC This service has been performed in part by a resident under the direction of a teaching physician
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
Date
Action
Notes
2017-01-01 Changed Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category.
2013-01-01 Added Added. Short and medium descriptions changed per AMA 2013 corrections document.
1986-12-31 Deleted Code deleted.
Code
Description
Code
Description
Code
Description
Code
Description
Code
Description
CasePilot

Get instant expert-level medical coding assistance.

Ask about:
CPT Codes Guidelines Modifiers Crosswalks NCCI Edits Compliance Medicare Coverage
Example: "What is CPT code 99213?" or "Guidelines for E/M services"