Summary & Overview
CPT 31638: Bronchoscopic Revision or Replacement of Airway Stent
CPT code 31638 covers rigid or flexible bronchoscopy performed to revise or replace a previously placed tracheobronchial stent, with optional fluoroscopic guidance and possible dilation of a narrowed airway before stent work. This procedure is clinically important for maintaining airway patency in patients with malignant or benign central airway obstruction and can directly affect respiratory function and downstream resource use.
Key national payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the service captured by this code, typical sites of service, common procedural elements (bronchoscopic visualization, stent revision/replacement, and potential dilation), and the payer landscape relevant to coverage and billing practice nationally. The article summarizes benchmarks for service utilization, coding and billing considerations, and clinical context to help coding and revenue teams, clinicians, and policy analysts understand how CPT code 31638 is used and why it matters for airway management programs.
Data not available in the input for specific associated taxonomies, ICD-10 diagnoses, related codes, and service-line financial benchmarks.
Billing Code Overview
CPT code 31638 describes a bronchoscopic procedure in which a clinician performs rigid or flexible bronchoscopy to visualize the trachea and bronchi and to revise or replace a previously placed airway stent. The procedure may include fluoroscopic guidance and can involve dilation of a narrowed airway segment prior to stent revision or replacement.
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Service type: Therapeutic bronchoscopic airway stent revision or replacement
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Typical site of service: Hospital operating room, ambulatory surgery center, or specialized endoscopy suite
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with a history of lung cancer previously treated with bronchoscopic stent placement presents with progressive dyspnea, cough, and recurrent atelectasis of the right lung. Imaging and bronchoscopy confirm stent migration and granulation tissue causing recurrent airway obstruction of the right mainstem bronchus. The interventional pulmonology team schedules a procedure in an operating room or bronchoscopy suite under general anesthesia or monitored sedation. The provider performs a rigid or flexible bronchoscopy with or without fluoroscopic guidance to inspect the airway, debride granulation tissue, dilate the stenotic segment if needed, and revise or replace the existing tracheobronchial stent. Intra-procedural actions may include balloon or mechanical dilation, removal of the old stent, placement of a new stent, and hemostasis. Post-procedure care includes recovery from anesthesia, chest radiography as indicated, and short-term observation for complications such as bleeding, pneumothorax, or respiratory distress. Documentation should include indication, pre-procedure airway assessment, type of bronchoscopy (rigid or flexible), use of fluoroscopy if applicable, details of stent revision or replacement, any dilation performed, devices used, anesthesia type, and immediate post-procedure status.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier reported; full global package | Use when no additional modifier is applicable and the service is billed alone |