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.
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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.
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Service type: Bronchoscopic marker placement performed during diagnostic or therapeutic bronchoscopy
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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 | Bilateral procedure | Use if markers are placed in anatomically bilateral bronchi/lesions during the same session when payer recognizes bilateral indicator. |
51 | Multiple procedures | Use to indicate multiple distinct procedures performed during the same encounter per payer rules. |
52 | Reduced service | Use when the marker placement is partially reduced or not completed as originally planned. |
53 | Discontinued procedure | Use when the procedure is started but terminated due to patient instability or other complications before marker placement is completed. |
58 | Staged or related procedure or service by the same physician during the postoperative period | Use when marker placement is part of a planned staged procedure performed during the global period of a related operation. |
62 | Two surgeons | Use if two surgeons with different skills are required and both participate in placement or associated operative steps. |
76 | Repeat procedure by same physician | Use when the same physician repeats the bronchoscopic marker placement during the postoperative period. |
77 | Repeat procedure by another physician | Use when a different physician repeats the marker placement during the postoperative period. |
78 | Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period | Use when marker placement or correction requires an unplanned return to the procedure room after an earlier related procedure. |
80 | Assistant surgeon | Use when an assistant surgeon is present and payer allows reporting for bronchoscopic marker placement. |
81 | Minimum assistant surgeon | Use when a minimal assistant involvement is reported per payer guidelines. |
LT | Left side | Use to identify procedures performed on the left lung or bronchial tree when laterality is required. |
RT | Right side | Use to identify procedures performed on the right lung or bronchial tree when laterality is required. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RC0000X | Pulmonary Disease | Interventional pulmonologists commonly perform bronchoscopic marker placement. |
| 2084P0800X | Thoracic Surgery | Thoracic surgeons perform bronchoscopic or endobronchial marker placement for surgical planning. |
| 207L00000X | Pulmonary Critical Care Medicine | Pulmonologists with critical care training perform bronchoscopic localization in inpatient and outpatient settings. |
| 207K00000X | Internal Medicine (Pulmonology is a subspecialty) | General pulmonologists perform diagnostic bronchoscopy and marker placement when trained. |
| 362A00000X | Diagnostic Radiology | Interventional radiologists may perform CT-guided marker placement; included here for team context when multimodal localization is used. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
C34.90 | Malignant neoplasm of unspecified part of unspecified bronchus or lung | Peripheral or central lung malignancy being localized for biopsy, surgery, or radiotherapy; common indication for marker placement. |
R91.8 | Other nonspecific abnormal finding of lung field | Indeterminate pulmonary nodule on imaging requiring localization for diagnosis or treatment planning. |
R91.1 | Solitary pulmonary nodule | Frequent indication for bronchoscopic localization and marker placement to guide resection or stereotactic radiotherapy. |
J98.4 | Other disorders of lung, not elsewhere classified | Used for nonspecific lung pathology where localization may assist targeted therapy or intervention. |
Z90.2 | Acquired absence of lung (partial) | Postoperative anatomy may require placement of markers for planning further therapy or re-intervention. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
31622 | Bronchoscopy, flexible or rigid, including fluoroscopic guidance, when performed; with bronchial or endobronchial biopsy(s), single or multiple | Often performed during the same session for tissue diagnosis prior to or in conjunction with marker placement. |
31623 | Bronchoscopy, flexible or rigid, including fluoroscopic guidance, when performed; with bronchial brushings, washings or protected specimen brush | Adjunct diagnostic sampling that may be performed in the same procedure before marker deployment. |
31628 | Bronchoscopy, flexible or rigid, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s) | Transbronchial biopsies may be performed during the same bronchoscopic session when parenchymal sampling is needed along with marker placement. |
77012 | CT guidance for placement of radiation therapy fields/placement of fiducial markers (separate procedure) | Used when percutaneous CT-guided fiducial marker placement is performed as an alternative or complement to bronchoscopic marker placement. |
77334 | Radiation treatment devices, design and construction, e.g., bolus, etc. (planning related codes) | Relates to subsequent radiation planning that uses bronchoscopically placed markers as fiducial references. |
75989 | Vascular embolization or occlusion, other than central nervous system, non-selective; with placement of radiopaque markers (unlisted/related code) | Sometimes reported for marker-related fluoroscopic procedures; included here as an uncommon related code in image-guided localization workflows. |