Summary & Overview
CPT 31649: Bronchoscopic Removal of Additional Lobe Bronchial Valves
CPT code 31649 is an add-on bronchoscopic procedure code for removal of one or more bronchial valves from an additional lobe of the lung during the same session after valves have been removed from an initial lobe. It captures a specific incremental service tied to bronchoscopic explantation of endobronchial valves and is relevant for billing when multiple lobes are treated in a single encounter. Nationally, the code matters because it ensures separate reporting and potential incremental payment for additional lobes treated during complex bronchoscopy sessions.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for valve removal and the service setting, plus what to expect in a national benchmarking and policy context. The publication outlines how the code is used in practice, typical sites of service, relationships to related bronchoscopy services, and where to look for payer guidance and authorization requirements.
The report provides benchmarks for utilization and reimbursement (where available), notes relevant coding considerations, and summarizes clinical circumstances in which bronchial valve removal add-on reporting is applicable. Data not available in the input will be identified as such in the detailed sections.
Billing Code Overview
CPT code 31649 describes an add-on bronchoscopic procedure in which the provider removes one or more bronchial valves from an additional lobe of the lung during the same session after removal from an initial lobe. The procedure is performed using bronchoscopic visualization.
Service type: Bronchoscopic bronchial valve removal — add-on procedure
Typical site of service: Hospital outpatient department or ambulatory surgical center, performed in a bronchoscopy suite or procedure room with endoscopic visualization.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with severe emphysema previously underwent bronchoscopic endobronchial valve placement to reduce hyperinflation. During a single bronchoscopy session, the interventional pulmonologist removes valves from one lobe and then removes one or more additional bronchial valves from an additional lobe using bronchoscopic visualization. The procedure is performed in an ambulatory surgery center or hospital operating room under moderate sedation or general anesthesia with continuous monitoring. The workflow includes pre-procedure imaging review (CT chest), airway inspection via flexible bronchoscopy, identification of previously placed valves, sequential removal of valves from the initial lobe, and then removal of additional valves from another lobe during the same session. Post-procedure observation includes chest radiograph to assess for pneumothorax, monitoring of respiratory status, and documentation of the number of valves removed and lobes treated. Billing reflects the primary bronchoscopic valve removal for the initial lobe and the add-on bronchoscopic removal of valves from the additional lobe using 31649 as the add-on code.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct procedural service | Use when services are separate and distinct from other procedures performed at the same session, if documentation supports separate approaches or sites. |