CPT® Code 31638

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with revision of tracheal or bronchial stent inserted at previous session (includes tracheal/bronchial dilation as required)

The procedure described by CPT® Code 31638 involves the use of a bronchoscope, which can be either rigid or flexible, to perform a detailed examination and intervention within the trachea and bronchi. This procedure includes fluoroscopic guidance when necessary, allowing for enhanced visualization during the intervention. The bronchoscope is inserted through the patient's nose or mouth and navigated into the oropharynx, where an initial examination occurs. The vocal cords are then visualized, followed by the advancement of the bronchoscope into the trachea, which is also thoroughly examined. The bronchoscope is further advanced into each mainstem bronchus to identify any abnormalities that may be present. In cases where a rigid bronchoscope is utilized, a telescope or flexible bronchoscope may be introduced through the rigid bronchoscope to facilitate visualization of the distal segments of the mainstem bronchi. A critical aspect of this procedure is the revision of a previously placed tracheal or bronchial stent that may have been improperly positioned or has migrated from its original placement. The physician may retrieve the stent, reposition it, or replace it with a new stent as needed. If there is a need for dilation prior to the stent revision, a balloon catheter is employed to open the obstructed or narrowed area by inflating the balloon one or more times. Subsequently, a stent delivery catheter or other stent delivery device is advanced through the bronchoscope to the targeted site, where the tracheal or bronchial stent is placed within the obstructed or stenosed lumen to restore and maintain airway patency.