Summary & Overview
CPT 31630: Bronchoscopy with Airway Dilation
CPT code 31630 denotes therapeutic bronchoscopy for dilation of tracheal or bronchial stenosis and treatment of tracheobronchial injury. The code covers rigid or flexible bronchoscopy performed to visualize the central airways and restore patency, using techniques such as balloon dilatation; fluoroscopic guidance may be used but is not required. This procedure is clinically important for managing airway obstruction from stenosis, trauma, or other lesions and carries implications for surgical, pulmonary, and interventional teams nationwide.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a national view of billing and clinical context relevant to hospitals, ambulatory surgical centers, and endoscopy suites. Readers will find benchmarks for utilization and reimbursement practices, coding and billing considerations tied to procedure components, and clinical context regarding indications and service settings. The report also highlights common modifiers and documentation elements encountered in claims (Data not available in the input for payer-specific rate tables).
Billing Code Overview
CPT code 31630 describes a bronchoscopic procedure in which a provider performs rigid or flexible bronchoscopy to visualize the trachea and bronchi and to treat central airway narrowing. The procedure typically includes dilation of tracheal or bronchial stenosis using techniques such as balloon dilatation and may address tracheobronchial fracture or other airway injuries. Fluoroscopic guidance may or may not be used.
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Service type: Therapeutic bronchoscopy with airway dilation
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Typical site of service: Hospital operating room or endoscopy suite; may also be performed in ambulatory surgical centers when clinically appropriate
Clinical & Coding Specifications
Clinical Context
A 58-year-old male with a history of prolonged endotracheal intubation presents with progressive dyspnea, stridor, and recurrent episodes of retained secretions. Imaging and flexible bronchoscopy demonstrate a focal tracheal stenosis approximately 2 cm in length with mucosal scarring and inward collapse. The interventional pulmonology team schedules a rigid or flexible bronchoscopy with balloon dilatation under general anesthesia in the operating room. The workflow includes preoperative assessment and consent, anesthesia induction, airway visualization with bronchoscopy, airway dilation (commonly with balloon dilatation), evaluation for airway injury or fracture, hemostasis as needed, possible placement of a temporary stent if dilation is inadequate, and post-procedure recovery with monitoring for airway compromise, bleeding, or respiratory distress. The procedure may use fluoroscopic guidance and concurrent bronchoscopic therapeutic maneuvers. Documentation elements include indication, bronchoscopic findings, dilation technique and size, use of fluoroscopy, complications, and disposition.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When work or complexity is substantially greater than usual for bronchoscopy with dilation (e.g., extensive scar tissue, prolonged time). |
23 |