CPT® Code 31652

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures

Bronchoscopy is a medical procedure that allows for direct visualization of the airways and lungs through the use of a bronchoscope, which can be either rigid or flexible. This procedure is enhanced by the use of endobronchial ultrasound (EBUS) guidance, which provides real-time imaging of the tracheobronchial wall and surrounding structures. The primary purpose of this procedure is to obtain tissue samples from the mediastinal and/or hilar lymph nodes, which are critical for diagnosing and staging various conditions, including carcinomas, lymphomas, sarcoidosis, silicosis, histoplasmosis, and tuberculosis. The hila refer to the areas where the major bronchi enter the lungs, while the mediastinal nodes are located in the central part of the chest, between the sternum and spine, surrounding the tracheobronchial tree. During the bronchoscopy, the physician may use a transoral or transnasal approach to insert the bronchoscope, allowing for a thorough examination of the vocal cords, trachea, and carina. The procedure involves advancing the bronchoscope into the left and right main bronchi and their branches, facilitating access to the lung tissue for sampling. EBUS technology significantly improves the quality of the tissue samples obtained, as it allows for precise targeting of the lymph nodes and structures of interest. The bronchoscope may be equipped with a transducer or a miniature probe to enhance imaging capabilities. Tissue samples can be collected through various methods, including biopsy forceps or needle aspiration, ensuring that adequate specimens are obtained for further analysis. This procedure is coded as CPT® 31652 when one or two mediastinal and/or hilar lymph node stations or structures are sampled, while CPT® 31653 is used for cases involving three or more stations.