2025 CPT code 31638
Effective Date: N/A Surgery - Surgical Procedures on the Respiratory System Feed
Bronchoscopy, rigid or flexible, with fluoroscopic guidance, with revision of a previously placed tracheal or bronchial stent, including tracheal/bronchial dilation.
Modifiers may be applicable. For example, modifier 22 (Increased Procedural Services) might be used if the procedure is significantly more complex than usual. Modifier 52 might be used if the procedure is reduced.
Medical necessity must be established by documenting the patient's condition necessitating stent revision (e.g., dyspnea, stenosis, stent malfunction). The medical record should demonstrate that the benefits of the procedure outweigh the risks.
The physician inserts a bronchoscope through the nose or mouth, examines the existing stent, and may adjust, remove, or replace it. Dilation of the airway may be performed before stent revision. Fluoroscopic guidance may be used.
In simple words: The physician uses a thin, flexible tube with a camera (bronchoscope) to view the airways and adjust or replace a stent (tube-shaped support) in the windpipe or lungs. An x-ray video (fluoroscopy) may be used for guidance. Widening of the airway (dilation) may be done if necessary.
This procedure involves a bronchoscopy, either rigid or flexible, with fluoroscopic guidance, to revise a previously placed tracheal or bronchial stent. This includes dilation of the trachea or bronchus as needed.
Example 1: A patient with a tracheal stent placed one year prior presents with breathing difficulties. A flexible bronchoscopy with fluoroscopic guidance is performed, and the stent is found to be partially obstructed. The stent is revised to improve airflow., A patient with a history of bronchial stenosis experiences recurrent cough. Rigid bronchoscopy is performed, the original stent is removed, and a new stent is placed to maintain airway patency., A patient post lung transplant experiences difficulty breathing due to airway complications. The existing stent is malpositioned, so during a bronchoscopy procedure it is removed and replaced.
Documentation should include the type of bronchoscope used (rigid or flexible), use of fluoroscopy, the location and type of stent revised, any dilation performed, and the reason for the revision. Pre- and post-procedure notes, including patient consent, should also be documented.
- RVU: 4.88 (as of 2015)
- Specialties:Pulmonology, Thoracic Surgery
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Ambulatory Surgical Center, and other facilities where bronchoscopy is performed.