Summary & Overview
CPT 31640: Bronchoscopic Airway Tumor Excision
CPT code 31640 represents a bronchoscopic procedure—rigid or flexible bronchoscopy—used to visualize the airways and excise an endobronchial tumor, with optional fluoroscopic guidance. This code is clinically important because it captures combined diagnostic and therapeutic airway interventions that can be performed in ambulatory procedure suites, endoscopy units, or operating rooms and may involve general or monitored anesthesia.
Key payers in the national landscape include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Coverage and payment policies for bronchoscopic tumor excision vary by payer and site of service, influencing billing workflows, prior authorization requirements, and facility versus professional fee splits.
Readers will learn a concise clinical and billing overview of CPT code 31640, typical sites of service, and the clinical context for use. The publication will also summarize common modifiers and payer considerations, and provide benchmarking and policy context where available. Data not available in the input will be noted as such in relevant sections.
Billing Code Overview
CPT code 31640 describes a bronchoscopic procedure in which a provider performs rigid or flexible bronchoscopy to visualize the airways and excise a tumor. The procedure may be performed with or without fluoroscopic guidance.
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Service type: Diagnostic and therapeutic bronchoscopic airway tumor excision
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Typical site of service: Operating room or procedure suite; may also occur in an endoscopy unit or hospital inpatient setting depending on clinical needs and anesthesia requirements
Clinical & Coding Specifications
Clinical Context
A 64-year-old patient with a history of chronic cough and hemoptysis is referred for diagnostic and therapeutic airway evaluation. Imaging (CT chest) identifies an endobronchial mass causing partial obstruction of the right mainstem bronchus. The pulmonologist schedules a bronchoscopy for direct visualization and excision of the visible tumor. The patient arrives to an outpatient endoscopy suite or hospital operating room after pre-procedure assessment, informed consent, and appropriate anesthesia planning (moderate sedation for flexible bronchoscopy or general anesthesia for rigid bronchoscopy). During the procedure, the provider performs a rigid or flexible bronchoscopy, may use fluoroscopic guidance if needed, visualizes the lesion, biopsies and excises the tumor endoscopically, and achieves hemostasis. Specimens are submitted to pathology. Post-procedure recovery includes monitoring for airway compromise, bleeding, or pneumothorax, and discharge instructions are provided once stable. Typical sites of service are the hospital operating room or ambulatory surgery/endoscopy suite.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician’s professional portion of a bundled service (typically for interpretation or professional act separate from technical facility charge). |