Summary & Overview
CPT 31624: Bronchial Alveolar Lavage via Bronchoscopy
CPT code 31624 represents bronchial alveolar lavage performed via rigid or flexible bronchoscopy, a procedure that uses saline to wash and recover cells from the alveoli for diagnostic or therapeutic purposes. The code is used nationally across hospital and ambulatory settings where bronchoscopy and potential fluoroscopic guidance are available. It captures both diagnostic sampling and lavage-based therapeutic interventions in the lower respiratory tract.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the procedure, typical sites of service, common modifiers in use, and how payers commonly classify and reimburse bronchoscopy-based lavage services. The summary also orients readers to operational considerations such as equipment needs (rigid or flexible bronchoscope, saline irrigation, optional fluoroscopy) and typical clinical indications for lavage sampling.
This publication provides benchmarks and policy context relevant to billing, coding, and payer coverage for CPT code 31624, plus guidance on documentation elements that support medical necessity. Data not provided in the input are noted where appropriate.
Billing Code Overview
CPT code 31624 describes a bronchial alveolar lavage performed using a rigid or flexible bronchoscope. The procedure involves instillation and aspiration of saline to wash cells from the alveoli, the air sacs at the ends of the bronchioles. The description notes that fluoroscopic guidance may be used during the procedure.
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Service type: Procedural diagnostic and therapeutic bronchoscopy with bronchial alveolar lavage
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Typical site of service: Hospital inpatient or outpatient setting, ambulatory surgery center, or other facility equipped for bronchoscopy and possible fluoroscopy
Clinical & Coding Specifications
Clinical Context
A 58-year-old man with a history of chronic cough, progressive dyspnea, and diffuse bilateral interstitial opacities on chest CT is referred for bronchoscopic evaluation. The pulmonologist performs bronchoalveolar lavage (BAL) using a flexible bronchoscope to obtain alveolar cellular and microbiologic samples to evaluate for suspected atypical infection, diffuse alveolar hemorrhage, or interstitial lung disease activity. The patient is brought to an outpatient endoscopy suite or hospital bronchoscopy unit, receives local anesthesia with topical lidocaine and moderate sedation (conscious sedation) administered by anesthesia or the bronchoscopist, and is continuously monitored with pulse oximetry, cardiac monitoring, and supplemental oxygen as needed. The bronchoscope is advanced to the targeted segment(s) under direct visualization; sterile saline aliquots are instilled and then aspirated for cytology, microbiology, and inflammatory cell counts. Fluoroscopic guidance may be used when focal peripheral sampling or radiographic localization is required. Post-procedure, the patient is observed in recovery until sedation effects have resolved and discharge criteria are met or admitted if clinically indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure | Use when the provider documents a distinct E/M service on the same day as BAL (e.g., new problem evaluation leading to bronchoscopy). |