CPT® Code 0276T

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Bronchial thermoplasty is a medical procedure designed to manage severe, persistent asthma in patients whose symptoms are not adequately controlled by standard inhaled corticosteroids and long-acting beta-agonists. This procedure involves the use of a bronchoscope, which can be either rigid or flexible, to access the airways. The bronchoscope is introduced through the patient's nose or mouth and navigated into the oropharynx, with fluoroscopic guidance utilized as necessary to ensure accurate placement. Once the bronchoscope reaches the trachea, it is further advanced into either the right or left mainstem bronchus. During this process, any abnormalities within the airways are carefully noted. If a rigid bronchoscope is employed, a telescope or flexible bronchoscope may be inserted through it to allow for visualization of the distal segments of each mainstem bronchus. The procedure specifically targets the airway walls, where a catheter containing a thermoplasty device is introduced and positioned at the first treatment site, typically the most distal airway within the targeted lobe. An electrode array is then placed against the airway wall, and the device is activated to deliver low-power, temperature-controlled radiofrequency (RF) energy for a maximum duration of 10 seconds at each targeted location. This RF energy effectively heats and destroys excessive smooth muscle tissue in the airway, which can restrict the airway's ability to contract. The electrodes are systematically repositioned and activated along all accessible airways distal to the mainstem bronchus within the lobe being treated. It is important to note that for the treatment of one lobe in a single session, the appropriate code to use is 0276T, while for the treatment of two or more lobes in a single session, the code 0277T should be utilized. Typically, multiple bronchial thermoplasty sessions are necessary, as only a limited portion of the lungs (1-2 lobes) can be treated during each session.