Summary & Overview
CPT 31626: Bronchoscopic Marker Placement
CPT code 31626 covers placement of one or more markers during a bronchoscopic examination to establish reference points for future treatment or surgery. The code captures an add-on service performed in conjunction with a standard bronchoscopy and has relevance for care pathways involving lesion localization, surgical planning, and follow-up interventions. Nationally, accurate reporting of this code affects procedure documentation, care coordination for thoracic procedures, and surgical planning workflows.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for marker placement during bronchoscopy, typical sites of service, and payer coverage considerations. The publication outlines common billing modifiers and coding relationships where available, benchmarks for utilization and reimbursement patterns when present, and policy updates or payer guidance that affect claims handling.
This summary equips clinicians, coding staff, and revenue-cycle professionals with a clear understanding of when CPT code 31626 applies, the clinical rationale for marker placement during bronchoscopy, and the operational issues to consider for preauthorization, documentation, and integration with subsequent surgical care. Data not available in the input.
Billing Code Overview
CPT code 31626 describes a bronchoscopic procedure in which, in addition to a standard bronchoscopic examination, the provider places one or more markers to create a reference point for future treatment or surgery. This service is typically performed by pulmonologists or thoracic surgeons.
-
Service type: Bronchoscopic marker placement performed during diagnostic or therapeutic bronchoscopy
-
Typical site of service: Hospital outpatient department or ambulatory surgical center; may also be performed in a bronchoscopy suite within a hospital or clinic setting
Clinical & Coding Specifications
Clinical Context
A typical patient is a 65-year-old current or former smoker with a newly detected, peripheral pulmonary nodule on chest CT being evaluated for suspected early-stage lung cancer. The patient presents to the outpatient bronchoscopy suite for a diagnostic flexible bronchoscopy. During the procedure the bronchoscopist performs a standard bronchoscopic survey and, using fluoroscopic or navigational guidance, places one or more fiducial or marker clips at or adjacent to the lesion to create a stable reference point for subsequent stereotactic radiotherapy, robotic-assisted resection, or image-guided surgery. The workflow includes pre-procedure evaluation and informed consent, moderate sedation or monitored anesthesia care, targeted bronchoscopic localization and marker deployment, post-procedure chest radiograph to confirm marker position and exclude pneumothorax if clinically indicated, and documentation of marker type, number, location, and any immediate complications. This service is reported in addition to the diagnostic bronchoscopy when marker placement is performed during the same bronchoscopic session.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the professional interpretation component if separate from technical services. |
50 |