CPT® Code 31649

Add-On Code

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of bronchial valve(s), each additional lobe (List separately in addition to code for primary procedure)

The procedure described by CPT® Code 31649 involves the removal of bronchial valves using either a rigid or flexible bronchoscope, which is a specialized instrument designed for visualizing the airways. Bronchial valves are devices placed within the bronchial passages to manage airflow and treat various pulmonary conditions. However, complications or a lack of patient benefit may necessitate their removal. During the procedure, the bronchoscope is inserted through the patient's nose or mouth and navigated through the oropharynx and trachea, ultimately reaching the mainstem bronchus. Fluoroscopic guidance may be utilized to enhance visualization and ensure accurate placement of the bronchoscope. Once the bronchoscope is positioned in the segmental or subsegmental bronchus where the valve is located, the valve and its surrounding structures are carefully examined. The central rod of the valve is then grasped with biopsy forceps, which facilitates the collapse of the valve, allowing for its removal. After the valve is extracted, the bronchoscope is reinserted to inspect the bronchial area for any signs of injury or complications. Finally, the bronchoscope is withdrawn, and a thorough examination of the bronchi, trachea, and oropharynx is conducted to ensure the integrity of these structures. This code is specifically used for the removal of bronchial valves from each additional lobe, following the primary procedure, which is coded separately.