Summary & Overview
CPT 31652: EBUS-Guided Transbronchial Needle Aspiration, 1–2 Stations
CPT code 31652 denotes a diagnostic bronchoscopy procedure using endobronchial ultrasound (EBUS) to perform transbronchial needle aspiration of one or two mediastinal or hilar lymph node stations. This code captures a commonly used minimally invasive technique for sampling intrathoracic lymph nodes, which can be pivotal in staging lung cancer, diagnosing infections, and evaluating other mediastinal pathology. Nationally, accurate coding for EBUS-TBNA affects procedure capture, quality measurement, and appropriate care pathways for patients with suspected pulmonary malignancy or unexplained lymphadenopathy.
Key payers typically involved in coverage and payment for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find benchmarks and contextual guidance on clinical indications, typical sites of service (hospital outpatient departments, ambulatory surgery centers, and inpatient procedure suites), and operational considerations related to procedure documentation and coding specificity. The publication outlines how CPT code 31652 is used to represent sampling of one or two lymph node stations via EBUS, compares common payer presence in national markets, and summarizes clinical context that drives utilization without offering clinical recommendations. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 31652 describes bronchoscopy with endobronchial ultrasound (EBUS)–guided transbronchial needle aspiration of one or two lymph node stations in the hilum and/or mediastinum. The procedure involves insertion of a rigid or flexible lighted endoscope into the lungs, with or without fluoroscopy, and use of ultrasound guidance within the trachea and bronchi to obtain tissue samples from targeted lymph nodes.
Service type: Diagnostic bronchoscopy with endobronchial ultrasound–guided transbronchial needle aspiration (EBUS-TBNA)
Typical site of service: Hospital outpatient department, ambulatory surgery center, or inpatient operating room/procedure suite
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with a 40-pack-year smoking history and a newly identified 3.2 cm right hilar mass on chest CT is scheduled for diagnostic sampling of mediastinal and hilar lymph nodes. The pulmonologist performs a bronchoscopy with endobronchial ultrasound (EBUS) using a flexible video bronchoscope with real-time ultrasound guidance to localize and biopsy lymph node stations 4R and 7. The procedure is performed in an outpatient endoscopy suite under moderate sedation with continuous monitoring of vital signs and pulse oximetry. Fluoroscopy is available but not routinely required. Samples are obtained with transbronchial needle aspiration and submitted for cytology, flow cytometry, and microbiology as indicated. Post-procedure recovery includes observation for bleeding or pneumothorax, discharge instructions, and follow-up to review pathology results.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician interpretation component separate from technical services. |
52 | Reduced services | Use when the procedure is partially reduced or not completed as planned. |