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2025 CPT code 0781T

Bronchoscopy with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance; bilateral mainstem bronchi.

This is a Category III code for emerging technology. If a Category III code is available, it must be reported instead of a Category I unlisted code. The inclusion of this code does not imply any endorsement of its clinical efficacy, safety, or payer coverage. The code will be archived five years from its initial release unless otherwise specified.

Modifiers may be applicable to this code depending on specific circumstances, such as increased procedural services (22), reduced services (52), or distinct procedural service (59).

Medical necessity is determined by the severity of the patient's underlying lung disease, failure of conventional therapies, and the potential for improvement in lung function or symptom relief.

After the patient is prepped and anesthetized, the provider inserts a bronchoscope through the nose or mouth to the bronchus. An esophageal protection device is positioned. A specialized catheter is inserted through the bronchoscope and positioned in the right or left mainstem bronchus. The catheter electrode is placed against the airway wall, sometimes using a balloon. Radiofrequency energy is activated in multiple positions to complete the ablation. The service is performed in both the right and left mainstem bronchi before instruments are removed.

IMPORTANT For unilateral mainstem bronchus treatment, use 0782T. If this code is unavailable, use the unlisted code 31899.

In simple words: The provider inserts a specialized catheter through a bronchoscope and completes a circumferential radiofrequency ablation in the main bronchus of each lung to destroy pulmonary nerves. A bronchoscope is a flexible or rigid tube inserted through the nose or mouth to view the airways. The bronchus is the main passageway to the lung. A catheter is a flexible tube inserted into a hollow structure. Radiofrequency ablation uses heat from radio waves to destroy damaged tissue.

Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi.

Example 1: A patient with severe COPD, unresponsive to medication, undergoes this procedure to reduce overactive airway nerves in both lungs., A patient with asthma uncontrolled by standard treatments undergoes this procedure to destroy pulmonary nerves and potentially alleviate symptoms., A patient with chronic bronchitis has this procedure in an attempt to improve lung function and reduce cough.

Documentation should include the type of bronchoscope used (rigid or flexible), confirmation of esophageal protection device placement, use of fluoroscopic guidance, laterality of treatment (bilateral mainstem bronchi), and a detailed operative report describing the procedure.

** As of December 10, 2024, this code is considered present and active. However, coverage and payment for this procedure may vary among payers. It's crucial to check with individual payers regarding their coverage policies.

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