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2025 CPT code 31651

Bronchoscopy with balloon occlusion, assessment of air leak, airway sizing, and insertion of bronchial valve(s), each additional lobe (List separately in addition to code for primary procedure[s]).

This code is for each additional lobe treated during the same session.Do not report this code for each additional valve placed within the same lobe.Only report once per each additional lobe treated.

Modifiers may be applicable to this code. For example, modifier 59 may be used to indicate a distinct procedural service.

Medical necessity for this procedure must be established by documenting the underlying condition causing the air leak (e.g., emphysema, bronchopleural fistula), the failure of conservative treatment, and the anticipated clinical improvement following the procedure.

The physician is responsible for performing the bronchoscopy, including the assessment of the air leak, sizing the airway, and placement of the bronchial valve(s) in each additional lobe.They must also ensure the correct placement of the valve and document the entire procedure.

In simple words: This procedure involves placing a small valve in an additional section of the lung to control air leakage, done during the same procedure as placing a valve in another part of the lung. The doctor uses a small camera to see inside the airways and may use an x-ray to guide the placement.

This add-on code describes the bronchoscopic placement of a bronchial valve in an additional lobe of the lung during the same operative session as placement in an initial lobe. It includes assessment of air leak, airway sizing, and the use of fluoroscopic guidance when performed.The procedure involves introducing a balloon catheter to the site of the air leak, potentially inflating it to stop the leak. A calibrating balloon is then used to measure the airway and select the appropriate valve size. The valve is subsequently inserted with the aid of a guidance instrument. Confirmation of correct placement is done before removing the bronchoscope.

Example 1: A patient with persistent air leaks in multiple lobes undergoes bronchoscopy. The physician places a bronchial valve in the right upper lobe (31647) and then places an additional valve in the right middle lobe (31651)., A patient with advanced emphysema has air leaks in the left upper and lower lobes.During the same bronchoscopy session, valves are inserted in both lobes. 31647 would be reported for the initial lobe and 31651 for the additional lobe., A patient with a large bulla in the right upper lobe and a smaller one in the right middle lobe undergoes bronchoscopic valve placement. During the same session, the physician addresses both areas with valves.31647 would be reported for the first placement, and 31651 for the placement in the additional lobe.

Documentation should include the size and location of the air leak, the size of the airway, the number and location of valves placed, the use of fluoroscopic guidance (if applicable), and any complications encountered.

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