2025 CPT code 31647
(Active) Effective Date: N/A Revision Date: N/A Surgery - Endoscopy Procedures on the Trachea and Bronchi Surgical Procedures on the Respiratory System Feed
Bronchoscopy (rigid or flexible), with balloon occlusion (when performed), air leak assessment, airway sizing, and initial lobe bronchial valve insertion; includes fluoroscopic guidance when performed.
Modifiers may apply depending on the specific circumstances of the procedure.Consult the most current CPT manual and local payer guidelines.
Medical necessity for this procedure is established when a patient presents with a persistent air leak, often following lung surgery or trauma, causing significant respiratory compromise.The valve placement is intended to improve ventilation, reduce air leak, and ultimately improve respiratory function and quality of life. The decision to proceed with this procedure requires a thorough evaluation by a pulmonologist or thoracic surgeon.
The physician performs the bronchoscopy, assesses the air leak, sizes the airway, and inserts the bronchial valve(s).The clinical team assists with anesthesia and other aspects of patient care.
In simple words: The doctor uses a thin, flexible tube with a camera (bronchoscope) to look inside your airways. They might use X-rays to help guide the procedure.They'll check for an air leak, measure the airway, and put a small valve in one part of your lung to control airflow.
This CPT code encompasses a bronchoscopy procedure, utilizing either a rigid or flexible bronchoscope, which includes fluoroscopic guidance if used.The procedure involves balloon occlusion (if performed), assessment of an air leak, precise airway sizing, and the insertion of a bronchial valve into the initial lobe of the lung.The procedure is reported only once for the initial lobe, even if multiple valves are placed within the lobe. Additional lobes require the use of add-on code +31651.
Example 1: A patient presents with a persistent air leak following a lung resection.Bronchoscopy with valve placement is performed to seal the leak and improve lung function., A patient with severe emphysema undergoes bronchoscopic placement of multiple valves in several lung segments to improve ventilation and reduce shortness of breath.Code 31647 is used for the initial lobe, and +31651 is added for each additional lobe., A patient with a traumatic lung injury experiences a persistent air leak.After initial attempts at sealing the leak with other methods fail, a bronchoscopic insertion of a bronchial valve is undertaken.The procedure is guided using fluoroscopy.
* Detailed operative report documenting the type of bronchoscope used (rigid or flexible), use of fluoroscopy, balloon occlusion (if performed), measurements of air leak and airway size, location and number of valves placed, and confirmation of valve placement.* Pre-operative and post-operative imaging (chest X-ray or CT scan) to confirm air leak and demonstrate valve placement.* Anesthesia records.* Patient history and physical exam findings relevant to the indication for the procedure.
** Always confirm payer coverage and specific coding requirements before billing.
- Revenue Code: P8F (Endoscopy - Bronchoscopy)
- RVU: Information not available in provided source.RVUs vary based on geographic location and other factors. Consult your local Medicare fee schedule or payer-specific information.
- Global Days: Information not available in provided source.The global period will vary depending on payer and other factors.
- Payment Status: Active
- Modifier TC rule: Information not available in provided sources.Modifier -TC may apply in specific situations; consult payer guidelines.
- Fee Schedule: Information not available in provided sources. Consult your local Medicare fee schedule or payer-specific information.
- Specialties:Pulmonology, Thoracic Surgery
- Place of Service:Ambulatory Surgical Center, Hospital (Inpatient or Outpatient), Office