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The procedure described by CPT® Code 31654 involves the use of a bronchoscope, which can be either rigid or flexible, to examine the airways. This procedure is performed by inserting the bronchoscope through the patient's nose or mouth, allowing access to the oropharynx, trachea, and mainstem bronchi. Fluoroscopic guidance may be utilized during this process to enhance visualization. The primary goal of this procedure is to identify any abnormalities within the airways. In conjunction with the bronchoscopy, a specialized miniaturized ultrasound probe is introduced through a flexible bronchoscope that has a biopsy channel. This ultrasound probe is specifically designed for transendoscopic endobronchial ultrasound (EBUS) and is employed during a primary diagnostic or therapeutic bronchoscopic intervention aimed at peripheral lesions. The ultrasound probe evaluates the airway walls, mediastinum, and lung structures. Once positioned within the airway, the probe's balloon tip is inflated to ensure full contact with the airway wall, allowing for detailed ultrasonic imaging of the wall structures and surrounding mediastinum. The probe is then maneuvered along the airway to provide a comprehensive evaluation of the airway and adjacent anatomical structures.
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The procedure described by CPT® Code 31654 is indicated for various clinical scenarios involving peripheral lesions. These indications may include:
The procedure involves several key steps that ensure thorough examination and evaluation of the airways and surrounding structures. These steps include:
After the completion of the bronchoscopy with EBUS, the patient is monitored for any immediate complications or adverse effects. Post-procedure care may include ensuring the patient is stable and recovering from sedation. The healthcare provider will assess the patient's vital signs and may provide instructions regarding any necessary follow-up care or further diagnostic testing based on the findings from the procedure. Patients may experience some throat discomfort or cough following the procedure, which is typically temporary. It is important for the healthcare team to provide clear guidance on signs of potential complications that the patient should report, such as difficulty breathing or excessive bleeding.
| Short Descr | BRONCH EBUS IVNTJ PERPH LES | Medium Descr | BRNSCHSC TNDSC EBUS DX/TX INTERVENTION PERPH LES | Long Descr | Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transendoscopic endobronchial ultrasound (EBUS) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion(s) (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 | 1 |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 31622 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure) | 31623 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with brushing or protected brushings | 31624 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage | 31625 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial or endobronchial biopsy(s), single or multiple sites | 31626 | MPFS Status: Active Code APC J1 ASC G2 CPT Assistant Article Illustration for Code Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of fiducial markers, single or multiple | 31628 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe | 31629 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i) | 31640 | MPFS Status: Active Code APC J1 ASC A2 Illustration for Code Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with excision of tumor | 31643 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of catheter(s) for intracavitary radioelement application | 31645 | MPFS Status: Active Code APC J1 ASC A2 Illustration for Code Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, initial | 31646 | MPFS Status: Active Code APC T ASC A2 CPT Assistant Article Illustration for Code Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, subsequent, same hospital stay |
| GC | This service has been performed in part by a resident under the direction of a teaching physician | 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. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | CR | Catastrophe/disaster related | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | 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). | 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). | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 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). | AI | Principal physician of record | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 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) | Q0 | Investigational 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) | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner |
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| 2017-01-01 | Changed | Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| 2016-01-01 | Added | Added |
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