CPT 31622: Diagnostic Bronchoscopy for Airway Visualization
CPT code 31622 represents a diagnostic bronchoscopy — a procedure using rigid or flexible endoscopy to inspect the tracheobronchial tree, often with fluoroscopic guidance and optional cell washing for cytology. This code is nationally relevant because bronchoscopy is a core diagnostic tool for a range of pulmonary conditions, including infection, inflammation, and suspected malignancy, and it frequently appears on hospital outpatient and ambulatory surgical service lines. Payers commonly covering services of this type include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn the clinical context in which 31622 is used, typical sites of service, common billing considerations, and how this code fits into procedural workflows. The publication outlines benchmarks and payment considerations across major payers, highlights typical service settings for diagnostic bronchoscopy, and summarizes policy or coding clarifications affecting use of the code. Data limitations: where input fields were not provided, the publication notes that specific taxonomy, ICD-10 pairings, and related code lists are not available in the input.
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Billing Code Overview
CPT code 31622 describes a diagnostic rigid or flexible bronchoscopy used to visualize the airways and evaluate suspected lung disease. The procedure may include fluoroscopic guidance and may involve cell washing to obtain cytologic samples of suspicious areas.
Service Type: Diagnostic bronchoscopy
Typical Site of Service: Hospital outpatient department, ambulatory surgery center, or endoscopy suite
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with a 40-pack-year smoking history presents with chronic cough, hemoptysis, and an abnormal chest CT showing a 2.5 cm endobronchial mass in the right mainstem bronchus. The pulmonologist schedules a diagnostic bronchoscopy to visualize the airway, obtain targeted samples, and perform bronchial washings or brushings for cytology. The procedure is performed in an operating room or endoscopy suite under moderate sedation or general anesthesia depending on patient comorbidities. During the visit, the provider documents informed consent, reviews anticoagulation status, performs pre-procedure airway assessment, and confirms imaging correlations. Rigid or flexible bronchoscopy is advanced to the level of the lesion; inspection is carried out and washings/brushings are obtained. Fluoroscopic guidance may be used if localization of a peripheral lesion is required. Post-procedure, the patient is monitored in a recovery area for airway complications and discharged home or admitted if complications or advanced therapy are needed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing the physician’s interpretation or performance separate from technical facility services. |
53 | Discontinued procedure | If the bronchoscopy is started but terminated early for patient safety reasons. |
52 | Reduced services | When the procedure is partially reduced or not completed as originally planned. |
57 | Decision for surgery | Not on the provided list; omitted. |
59 | Distinct procedural service | When bronchoscopy is performed on a separate anatomical site or a distinct procedural encounter from other services (use cautiously per payer guidance). |
76 | Repeat procedure by same physician | If the same provider repeats the bronchoscopy later the same day. |
77 | Repeat procedure by another physician | Not on the provided list; omitted. |
22 | Unusual procedural services | When work required is substantially greater than typical for bronchoscopy (document justification). |
25 | Significant, separately identifiable evaluation and management service | When a significant E/M is performed on the same day as bronchoscopy and needs separate payment. |
24 | Unrelated E/M during postop period | Not on the provided list; omitted. |
50 | Bilateral procedure | Generally not applicable to bronchoscopy; included in list but rarely used for this code. |
73 | Discontinued outpatient hospital/ambulatory surgery center | When procedure discontinued after anesthesia in ASC or outpatient hospital setting. |
74 | Discontinued inpatient procedure after anesthesia | When procedure discontinued after anesthesia in inpatient setting. |
62 | Two surgeons | When two surgeons equally share the procedure (rare for diagnostic bronchoscopy). |
95 | Synchronous telemedicine service rendered via real-time interactive audio and video telecommunications system | Not on provided list; omitted. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207RP1001X | Pulmonary Disease | Pulmonologists commonly perform diagnostic rigid or flexible bronchoscopy and sample acquisition. |
207L00000X | Thoracic Surgery | Thoracic surgeons perform bronchoscopy in operative settings or when combined with surgical procedures. |
2084P0800X | Critical Care Medicine | Intensivists may perform bronchoscopy in the ICU for airway assessment, secretion clearance, or sampling. |
207K00000X | Allergy & Immunology | (Less common) may perform bronchoscopic procedures in specialized diagnostic contexts. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
J98.01 | Acute bronchospasm | Indication to visualize airways or evaluate causes of airway obstruction prompting bronchoscopy. |
R04.2 | Hemoptysis, not elsewhere classified | Common indication to locate bleeding source and obtain samples. |
R05 | Cough | Persistent or unexplained cough can prompt bronchoscopy for diagnosis. |
C34.90 | Malignant neoplasm of unspecified part of unspecified bronchus or lung | Suspected lung cancer requiring endobronchial visualization and cytology/biopsy. |
J84.10 | Pulmonary fibrosis, unspecified | Interstitial lung disease cases may need bronchoscopy with washings for evaluation. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
31623 | Bronchoscopy, rigid or flexible, with bronchial or endobronchial biopsy(s) | Often performed during the same session when suspicion of tumor or focal lesion requires tissue biopsy in addition to washings. |
31624 | Bronchoscopy, with transection, or other cutting procedures of endobronchial lesion | Performed when therapeutic removal or debulking of an obstructing endobronchial lesion is required after diagnostic inspection. |
31625 | Bronchoscopy with removal of foreign body | May be performed in the same workflow if a foreign body is visualized and requires extraction. |
31628 | Bronchoscopy, with placement of intrabronchial stent | Performed after diagnostic bronchoscopy if significant airway obstruction requiring stenting is identified. |
31631 | Bronchoscopy, with endobronchial ultrasound (EBUS) guided transbronchial needle aspiration | Often done in the same episode when mediastinal or hilar lymph node sampling is needed for staging or diagnosis. |