CPT® Code 31653

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more 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 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 access the airways through either a transoral or transnasal approach, allowing for a thorough examination of the vocal cords, trachea, and carina. The bronchoscope is then advanced into the left and right main bronchi and their respective branches. The integration of EBUS technology significantly enhances the ability to visualize and sample lymph nodes, improving the quality and accuracy of the tissue samples obtained. The procedure may involve various techniques, including transtracheal and transbronchial biopsies, where biopsy forceps or needle aspiration methods are employed to collect tissue samples from three or more mediastinal and/or hilar lymph node stations or structures, as indicated by the CPT® Code 31653.