CPT® Code 31660

Bronchial thermoplasty is a specialized medical procedure aimed at treating severe, persistent asthma in patients who do not achieve adequate control with standard inhaled corticosteroids and long-acting beta-agonists. This procedure involves the use of a bronchoscope, which can be either rigid or flexible, to access the airways. The bronchoscope is introduced through the patient's nose or mouth and is guided into the oropharynx, with fluoroscopic guidance utilized as necessary to ensure accurate placement. Once the bronchoscope reaches the trachea, it is further advanced into either the right or left mainstem bronchus. During this process, any abnormalities within the airways are carefully noted. If a rigid bronchoscope is employed, a telescope or flexible bronchoscope may be inserted through it to allow for visualization of the distal segments of each mainstem bronchus. The procedure specifically targets the airway walls, where a catheter containing a thermoplasty device is introduced and positioned at the first treatment site, typically the most distal airway within the targeted lobe. An electrode array is then placed against the airway wall, and the device is activated to deliver low-power, temperature-controlled radiofrequency (RF) energy. This energy is applied for a maximum of 10 seconds at each location, effectively heating the airway wall to destroy excessive smooth muscle tissue. This reduction in smooth muscle mass decreases the airways' ability to constrict and narrow, which is a significant factor in asthma exacerbations. The electrodes are systematically repositioned and activated along all accessible airways distal to the mainstem bronchus within the lobe being treated. It is important to note that this code, 31660, is specifically used for the treatment of one lobe in a single session, while 31661 is designated for the treatment of two or more lobes in a single session. Typically, multiple bronchial thermoplasty sessions are necessary, as only a portion of the lungs (1-2 lobes) can be treated during each session.