CPT® Code 31651

Add-On Code

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), each additional lobe (List separately in addition to code for primary procedure[s])

Bronchoscopy, as described by CPT® Code 31651, is a medical procedure that involves the examination of the airways using a bronchoscope, which can be either rigid or flexible. This procedure is particularly focused on assessing the airways for size and identifying any air leaks. The bronchoscope is inserted through the mouth and navigated through the oropharynx and trachea, ultimately reaching the right or left mainstem bronchus. Fluoroscopic guidance may be utilized during this process to enhance visualization and accuracy. Once the bronchoscope is positioned in the segmental or subsegmental bronchus of the lobe suspected of containing an air leak, the healthcare provider can visualize and evaluate the structures within the airway. A calibrated balloon catheter is employed for airway sizing, allowing for precise measurement of the airway dimensions. Intermittent balloon occlusion is used to identify the specific airways that are contributing to the air leakage. The balloon catheter is advanced and inflated while monitoring the air leak in a water seal chamber. If a reduction or cessation of the air leak is observed, a delivery catheter is then advanced through the bronchoscope to place a bronchial valve. Following the placement of the valve, 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 Finally, the bronchoscope is withdrawn, and a thorough examination of the bronchi, trachea, and oropharynx is conducted to ensure comprehensive assessment. It is important to report CPT® Code 31651 for each additional lobe treated after the initial lobe has been addressed, as indicated by the related code 31647.