CPT 31631: Bronchoscopic Tracheal Stent Placement with Dilation
Headline: CPT code 31631: Bronchoscopic Tracheal Stent Placement with Possible Dilation
Lead: CPT code 31631 covers bronchoscopic placement of one or more stents into a narrowed tracheal segment, often following dilation of the stenosis; the procedure may use rigid or flexible bronchoscopy and can be performed with fluoroscopic guidance. The code matters nationally because airway stenting is a critical, potentially life-saving intervention for tracheal obstruction from benign or malignant causes, with implications for hospital capability, reimbursement patterns, and access to interventional pulmonology.
This analysis addresses common national payers — Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare — and summarizes clinical context, coding considerations, and expected service settings. Readers will find a concise clinical description of the service, the typical site of service and service type, common modifiers and payer considerations (where available), and an outline of what to expect in coverage and billing workflows. The report highlights benchmarks and policy developments relevant to advanced airway interventions, and it provides the clinical framing needed for coding accuracy, appropriate claims submission, and alignment with facility capabilities. Data not available in the input are noted where applicable.
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Billing Code Overview
CPT code 31631 describes bronchoscopic placement of one or more stents in a narrowed segment of the trachea. The procedure is performed via rigid or flexible bronchoscopy to visualize the airway; fluoroscopic guidance may be used. If necessary, the clinician may perform dilation of the stenotic segment before placing the stent.
Service type: Therapeutic interventional bronchoscopic procedure (airway stent placement, with possible dilation)
Typical site of service: Hospital operating room or ambulatory surgical center (procedure performed in a procedural suite with bronchoscopy capability)
Clinical & Coding Specifications
Clinical Context
A 62-year-old male with a history of smoking and prior head and neck radiation presents with progressive dyspnea, stridor, and cough. Imaging (CT chest) and bronchoscopy demonstrate a symptomatic tracheal stenosis measuring 60% lumen compromise just below the vocal cords. The interventional pulmonologist schedules a bronchoscopy with possible dilation and placement of an endoluminal tracheal stent to restore airway patency. The procedure is performed in an operating room or outpatient endoscopy suite under general anesthesia with flexible or rigid bronchoscopy; fluoroscopic guidance may be used. The team documents pre-procedure airway assessment, informed consent, anesthesia type, intraprocedural findings (location and length of stenosis), any dilation maneuvers, stent model/size, stent placement verification (endoscopic and/or fluoroscopic), and post-procedure respiratory status and disposition. Postoperative orders include chest radiograph to confirm stent position, pulse oximetry monitoring, and follow-up bronchoscopy scheduling for surveillance or stent adjustment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal or uncomplicated service | Use when the bronchoscopy with stent placement is performed without unusual procedural difficulty beyond typical expectations. |
22 | Increased procedural services | Use when documentation supports substantially greater work (e.g., prolonged procedure, extensive adhesiolysis, multiple dilations) beyond typical. |
23 | Unusual anesthesia | Use when significant anesthesia risk or general anesthesia is required for reasons unrelated to the procedure complexity documented. |
52 | Reduced services | Use when the procedure is attempted but not completed (e.g., inability to pass bronchoscope to lesion) with appropriate documentation. |
53 | Discontinued procedure | Use when the procedure is terminated for patient safety reasons after initiation. |
58 | Staged or related procedure planned | Use when the stent placement is part of a planned staged treatment (e.g., initial dilation followed by later definitive stent placement). |
62 | Two surgeons | Use when two qualified physicians work together as primary surgeons during the procedure and both document participation. |
78 | Unplanned return to OR for related procedure during global period | Use when the patient requires a return to the operating room for a complication related to the stent placement within the global period. |
80 | Assistant surgeon | Use when an assistant surgeon performs part of the procedure and documentation supports assistant services. |
81 | Minimum assistant surgeon | Use when documentation supports a minimum assistant rather than a full assistant surgeon. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | Use when an advanced practice clinician is documented as the surgical assistant. |
TC | Technical component | Use when billing only the technical component of a service (e.g., facility billing for equipment/fluoroscopy) separate from the professional component. |
QX | Modifier for CRNA not employed by anesthesiologist | Use when a CRNA furnishes anesthesia and documentation meets modifier criteria. |
ET | Initial inpatient/observation service | Use on hospital billing to indicate initial inpatient or observation encounter when applicable to facility reporting. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RP0000X | Thoracic Surgery | Common specialty performing airway stent placement for tracheal pathology. |
| 207RH0000X | Otolaryngology (ENT) | Frequently performs rigid bronchoscopy and stent placement for upper tracheal lesions. |
| 2084P0800X | Pulmonary Disease (Interventional Pulmonology) | Interventional pulmonologists commonly perform flexible/rigid bronchoscopy with stenting. |
| 2086S0123X | Critical Care Medicine | May be involved for complex airway management and perioperative critical care. |
| 362K00000X | Vascular Surgery / Interventional Radiology (overlap) | Interventional radiologists may assist with fluoroscopic guidance or complex stent deployment. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
J95.2 | Tracheal stenosis | Direct indication for tracheal stent placement to restore airway patency. |
J98.01 | Acute bronchospasm | May complicate airway procedures and be present in patients with obstructive airway physiology undergoing bronchoscopy. |
J84.10 | Pulmonary fibrosis, unspecified | Fibrotic airway distortion can contribute to central airway compromise requiring stenting. |
C34.90 | Malignant neoplasm of unspecified part of bronchus or lung | Central airway tumors can cause malignant airway obstruction treated with stent placement. |
T85.49XA | Infection and inflammatory reaction due to other internal prosthetic devices, implants and grafts, initial encounter | Relevant for complications after stent placement such as infection or inflammatory reaction requiring intervention. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
31622 | Bronchoscopy, rigid or flexible, with tracheal or bronchial dilation (eg, by Savary, balloon, bougienage) | Performed when dilation of the stenotic segment is required before or instead of stent placement; often performed in the same session. |
31623 | Bronchoscopy, rigid or flexible, with tracheal or bronchial dilation; with placement of intraluminal airway stent (eg, tracheal stent) — single procedure code related to stent placement without specifying multiples | Alternative code reported for stent placement scenarios when documentation aligns; used per coding guidance to reflect stent placement services. |
31500 | Intubation, endotracheal, emergency procedure | May be required emergently for airway protection prior to definitive airway stent procedure in unstable patients. |
76000 | Fluoroscopic guidance; initial procedure | Used when fluoroscopic guidance is employed during stent positioning and a facility bills for the imaging technical component. |
31575 | Bronchoscopy, rigid or flexible, with removal of foreign body, granulation tissue, stent or airway prosthesis | Used for follow-up procedures to revise, reposition, or remove previously placed airway stents or to clear obstructing granulation tissue. |