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2025 CPT code 31649

Removal of bronchial valve(s) from each additional lobe of the lung during bronchoscopy.

Code 31649 is an add-on code and should always be reported in addition to 31648 when valves are removed from more than one lobe during the same procedure. It is not reported alone.

Modifiers may be applicable to this code depending on the circumstances of the procedure. Consult modifier guidelines for specific scenarios.

Medical necessity for removal of bronchial valves is determined by the patient's respiratory condition and the effectiveness of the valve treatment. Documentation should show how this procedure is necessary for the patient's health.

At the same session that the provider removes one or more valves from an initial lobe, the provider moves her instruments to an additional lobe. She locates a bronchial valve under bronchoscopic visualization and removes the valve from the additional lobe using biopsy forceps. The provider may repeat the procedure for additional valves in the same lobe. The provider removes the bronchoscope slowly after removing the valves.

IMPORTANT:(Use 31649 in conjunction with 31648)

In simple words: This is an added procedure where the doctor removes extra bronchial valves from additional lobes of the lung during the same procedure where they removed valves from an initial lobe. They use a small camera to see inside the airways.

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of bronchial valve(s), each additional lobe (List separately in addition to code for primary procedure)

Example 1: A patient with severe emphysema has bronchial valves placed in two different lobes of their right lung. During a single bronchoscopy procedure, the physician removes the valves from both lobes. 31648 is reported for the first lobe and 31649 for the second lobe., A patient has a bronchial valve placed in the right upper lobe and another in the left upper lobe for treatment of persistent air leaks. The physician removes valves from both lobes using bronchoscopy visualization. 31648 is reported for removal from the first lobe. Then, 31649 is reported for removal from the second lobe during the same operative session., During a follow-up bronchoscopy, the physician removes valves from three separate lobes. Code 31648 is reported for the removal of the first lobe. Then, code 31649 is reported twice; once for each of the other lobes.

Documentation should support medical necessity for valve removal. It should also clearly specify the number of lobes from which valves were removed, and the laterality (right or left) of the lung lobes.

** This code was added in 2013. It is important to count the lobes involved, not the number of valves, when determining how many times to report 31649.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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