CPT® Code 31643

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of catheter(s) for intracavitary radioelement application

The procedure described by CPT® Code 31643 involves the use of a bronchoscope, which can be either rigid or flexible, to perform a detailed examination of the airways. The bronchoscope is inserted through the patient's nose or mouth and advanced into the oropharynx, allowing for a thorough visual inspection of the area. Fluoroscopic guidance may be utilized during the procedure to enhance visualization and ensure accurate placement of instruments. The examination includes the vocal cords and extends into the trachea, where any abnormalities can be identified. The bronchoscope is further advanced into each mainstem bronchus, facilitating a comprehensive assessment of the bronchial passages. In cases where a rigid bronchoscope is employed, a telescope or flexible bronchoscope may be inserted through it to visualize the distal segments of the mainstem bronchi more effectively. Once the examination is complete, an afterloading catheter is advanced through the bronchoscope to the targeted tumor area. If additional catheters are necessary for the procedure, the process is repeated to ensure proper placement. The position of the catheters is confirmed using fluoroscopy, which provides real-time imaging to verify accuracy. Following this, the patient is transferred to a shielded room where a radioactive source is afterloaded into the catheters using a remote device. This step is critical as it involves the application of intracavitary radioelements, a process known as brachytherapy, which is performed by a radiation oncologist and is reported separately. This procedure is essential for delivering targeted radiation therapy directly to the tumor site, maximizing treatment efficacy while minimizing exposure to surrounding healthy tissues.