Summary & Overview
CPT 31623: Bronchoscopic Brushing for Lung Tissue Sampling
CPT code 31623 represents bronchoscopic brushing or protected brushing using a rigid or flexible bronchoscope to collect cytologic or pathologic samples from lung tissue or lesions; fluoroscopic guidance may be used. This code is important nationally because bronchoscopic sampling is a core diagnostic tool in pulmonary medicine for evaluating masses, lesions, and diffuse lung disease. Accurate coding influences clinical documentation, facility and professional billing, and downstream quality measurement tied to diagnostic pathways.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for when 31623 is used, typical settings where the service is provided, and how this code fits into broader bronchoscopic diagnostic workflows. The publication summarizes common modifiers and related administrative considerations, highlights benchmarks and payer coverage patterns where available, and points to policy and coding nuances that affect billing and reimbursement. Data not available in the input for specific payer fee schedules, ICD-10 pairings, and provider taxonomy mappings is noted as unavailable. The emphasis is national in scope and aimed at coding professionals, hospital billing teams, and clinical leaders seeking a clear, practical reference for CPT code 31623.
Billing Code Overview
CPT code 31623 describes bronchoscopic brushing or protected brushing performed with a rigid or flexible bronchoscope. In this procedure the provider uses a soft brush to gently wipe lung tissue or to scrape a lesion to obtain cytologic or pathologic material. The procedure may be performed with fluoroscopic guidance when needed.
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Service type: Bronchoscopic diagnostic procedure (airway endoscopy with brushing)
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Typical site of service: Hospital inpatient, hospital outpatient department, or ambulatory surgical center; may also be performed in endoscopy suites or interventional pulmonology clinics depending on facility capabilities.
Clinical & Coding Specifications
Clinical Context
A 64-year-old current or former smoker presents with persistent hemoptysis and a focal, suspicious peripheral pulmonary nodule identified on chest CT. Pulmonary medicine or thoracic surgery schedules a bronchoscopy with brushings using a flexible bronchoscope under conscious sedation or general anesthesia. In the procedure suite or endoscopy unit the provider performs airway inspection, identifies an endobronchial lesion or area of abnormal mucosa, and obtains brushings with a soft cytology brush for cytologic analysis. Fluoroscopic guidance may be used to localize peripheral lesions. Samples are placed in cytology medium and sent to pathology. Typical site of service is an outpatient endoscopy or ambulatory surgery center, hospital outpatient department, or inpatient operating room for patients already admitted. The service type is diagnostic bronchoscopic sampling (bronchoscopic brushing/protected brushing) performed by a pulmonologist or thoracic surgeon for cytologic evaluation of suspected malignancy, infection, or unexplained pulmonary infiltrate.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the physician professional portion is reported separately from the technical component (rare for bronchoscopy imaging). |
50 |