Summary & Overview
CPT 31648: Bronchoscopic Removal of Previously Placed Bronchial Valve(s)
CPT code 31648 designates bronchoscopic removal of one or more previously placed bronchial valves. The procedure involves endoscopic visualization of the bronchial tree and extraction of implanted valves, typically performed in outpatient settings such as hospital outpatient departments or ambulatory surgical centers. This code captures a focused, device-related airway procedure that is relevant to interventional pulmonology and thoracic surgery practices.
Nationally, accurate coding for device removal procedures like 31648 matters for quality tracking, device lifecycle management, and appropriate reimbursement for complex bronchoscopic services. Key payers included in this coverage set are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn the clinical context for use of the code, common sites of service, and which major payers are relevant to coverage and claims adjudication. The publication provides benchmarks and policy context where available, explains clinical indications implied by the procedure, and highlights documentation elements that typically support billing for a bronchoscopic valve removal. Data not available in the input for specific modifiers, associated taxonomies, ICD-10 diagnoses, and related codes is noted elsewhere in the full publication.
Billing Code Overview
CPT code 31648 describes a procedure in which, under bronchoscopic visualization, the provider removes one or more previously placed bronchial valves from the bronchus. This is an airway intervention performed endoscopically using a bronchoscope to locate and extract implanted bronchial valve devices.
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Service type: Bronchoscopic removal of previously placed bronchial valve(s)
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Typical site of service: Hospital outpatient department or ambulatory surgical center where bronchoscopic airway procedures are performed
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with severe heterogeneous emphysematous chronic obstructive pulmonary disease (COPD) who previously underwent bronchoscopic placement of one-way endobronchial valves to reduce hyperinflation presents for elective removal of malfunctioning or ineffective valves. The patient reports progressive dyspnea and recurrent pneumonias localized to the treated lobe, or follow-up imaging demonstrates valve migration or absence of expected lobar volume reduction. Pre-procedure evaluation includes review of prior bronchoscopic reports, chest CT to assess valve position and lung anatomy, pulmonary function testing, and optimization of comorbidities.
The procedure is performed in an ambulatory surgery center or hospital bronchoscopy suite under moderate sedation or general anesthesia. Under bronchoscopic visualization, the interventional pulmonologist identifies previously placed bronchial valves and removes one or more devices using appropriate retrieval tools. The team monitors oxygenation, hemodynamics, and airway status during and after the procedure. Post-procedure care includes chest radiography if clinically indicated, assessment for pneumothorax, respiratory monitoring, and discharge planning with follow-up clinic evaluation and pulmonary rehabilitation as needed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Provider's usual (default) service | When reporting a non-distinct or standard removal performed by the primary surgeon or proceduralist. |