CPT® Code 31648

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of bronchial valve(s), initial lobe

The procedure described by CPT® Code 31648 involves the removal of bronchial valve(s) from an initial lobe of the lung, utilizing either a rigid or flexible bronchoscope. A bronchial valve is a device implanted in the bronchial passages to manage conditions such as obstructive lung disease; however, complications or a lack of patient benefit may necessitate its removal. During the procedure, the bronchoscope is inserted through the patient's nose or mouth and navigated through the oropharynx and trachea, eventually reaching the right or left mainstem bronchus. Fluoroscopic guidance may be employed to enhance visualization and ensure accurate placement of the bronchoscope. Once the bronchoscope is positioned in the segmental or subsegmental bronchus that contains the valve, the valve and its surrounding structures are carefully visualized and assessed. The central rod of the valve is then grasped using biopsy forceps, which facilitates the collapse of the valve, allowing for its removal. After the valve is extracted, 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 Finally, the bronchoscope is withdrawn, and a thorough examination of the bronchi, trachea, and oropharynx is conducted to ensure no complications have arisen during the procedure.