Summary & Overview
CPT 31651: Bronchial Valve Placement, Additional Lobe
CPT code 31651 is an add-on bronchoscopic procedure for placing an additional bronchial valve in a different lobe during the same session after initial valve placement, with assessment of air leak extent and airway size via bronchoscopic visualization. This code captures supplemental work in complex lung interventions and matters nationally as bronchial valve therapies expand for management of persistent air leaks and select emphysema cases. Payers commonly relevant to national coverage and reimbursement discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn the clinical context of the code, typical settings where the service is delivered, and which major payers are examined. The publication provides benchmarks and policy-relevant summaries related to billing and coding for bronchoscopic valve procedures, clarifies the add-on nature of 31651, and outlines what constitutes the additional procedure versus the primary valve placement within the same session. Data not available in the input for specific proprietary fee schedules, payer-specific coverage criteria, ICD-10 pairings, and associated taxonomies are noted as unavailable and not inferred. The focus is national in scope and intended to inform billing, coding, and administrative decision-makers about the role and classification of CPT code 31651.
Billing Code Overview
CPT code 31651 describes an add-on bronchoscopic procedure in which the provider assesses the extent of an air leak and the size of the involved bronchial airway and then places an additional bronchial valve in a separate lobe during the same session. The procedure is performed using bronchoscopic visualization.
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Service type: Bronchoscopic airway intervention (bronchial valve placement), add-on procedure
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Typical site of service: Hospital operating room or endoscopy/bronchoscopy suite, or other settings where bronchoscopic interventions are performed
Clinical & Coding Specifications
Clinical Context
A typical patient is a 65-year-old former smoker with severe heterogeneous emphysema and persistent air leak or hyperinflation causing dyspnea despite maximal medical therapy. The patient has undergone pre-procedure evaluation including CT chest to identify target lobes, pulmonary function testing (FEV1, DLCO), arterial blood gas assessment, and multidisciplinary review. During the bronchoscopic session under moderate sedation or general anesthesia in an endoscopy or operating room setting, the bronchoscopist performs airway inspection and assesses collateral ventilation and the extent of air leak. An initial endobronchial valve is placed in one lobe; when additional lobar treatment is required in the same session, the provider performs the add-on bronchoscopic placement described by 31651 and deploys another valve in an additional lobar bronchus. Post-procedure monitoring includes chest radiography to confirm valve position and evaluate for pneumothorax, respiratory monitoring in a PACU or inpatient setting, and follow-up pulmonary clinic visits to assess symptom and spirometric changes.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the physician professional portion of the service is billed separately from facility services. |