CPT 31717: Tracheal Brush Biopsy for Airway Sampling
CPT code 31717 represents a minimally invasive airway sampling procedure in which a catheter-mounted brush is advanced into the trachea to collect brush biopsy specimens for cytology and pathology. This code captures a focused diagnostic technique used when endoscopic visualization or suspicion of airway mucosal disease requires targeted cellular sampling. Nationally, procedures like this affect hospital outpatient and ambulatory surgery workflows, pathology utilization, and reimbursement policy for respiratory and thoracic diagnostic services.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for CPT code 31717, typical sites of service, common billing considerations, and how the procedure fits into broader diagnostic pathways for airway disease. The publication supplies benchmarks and coding guidance relevant to billing teams and revenue cycle professionals, highlights possible policy updates that influence coverage and documentation expectations, and situates the code among related endoscopic and pathology services.
This summary is intended for a national audience of clinicians, coding professionals, and policy analysts seeking a practical overview of CPT code 31717 and its role in respiratory diagnostic care.
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Billing Code Overview
CPT code 31717 describes a procedure in which a provider advances a catheter with an attached brush through the trachea to the target airway site to obtain brush biopsies for pathology. This is an airway sampling procedure performed to collect cellular specimens from the trachea or bronchial tree for diagnostic evaluation.
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Service type: Endoscopic airway brushing/biopsy
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Typical site of service: Hospital outpatient department or ambulatory surgery center, often performed in conjunction with bronchoscopy or other airway endoscopy procedures
Clinical & Coding Specifications
Clinical Context
A typical patient is a 62-year-old current or former smoker who presents with persistent cough, hemoptysis, or an abnormal chest imaging study (CT chest showing a suspicious endobronchial lesion or focal airway narrowing). The pulmonology team evaluates the patient in an outpatient bronchology suite or an inpatient bronchoscopy unit. After pre-procedure assessment and informed consent, the patient undergoes flexible bronchoscopy under moderate sedation or general anesthesia. The provider advances a protected catheter with an attached cytology brush through the bronchoscope into the trachea and bronchial tree to the target lesion. Brush biopsies are obtained for cytologic and pathologic analysis when forceps biopsies are not feasible or to complement tissue biopsies. Specimens are submitted to pathology and cytology for tumor cell identification, microbiology, or ancillary testing (e.g., molecular studies). Typical sites of service are the hospital operating room, endoscopy/bronchoscopy suite, or outpatient ambulatory surgical center. Indications include evaluation of suspected malignancy, central airway lesions, unexplained hemoptysis, or cytologic surveillance of known airway disease.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the physician’s interpretive or professional portion separate from the technical component (rare for this code). |
52 | Reduced services | Use when the procedure is partially reduced or not completed as originally planned. |
53 | Discontinued procedure | Use when the procedure is terminated due to patient condition or unexpected circumstances before completion. |
59 | Distinct procedural service | Use to indicate a separate and distinct procedure when another service was performed the same day and documentation supports distinctness. |
62 | Two surgeons | Use when two surgeons work together as primary surgeons performing distinct portions of a complex procedure. |
66 | Surgical team | Use when a surgical team approach with multiple physicians is required. |
78 | Unplanned return to OR/procedure | Use when the patient returns to the operating room or procedure suite for a related procedure during the postoperative period. |
80 | Assistant surgeon | Use when an assistant surgeon (not a resident) assists with the procedure. |
81 | Minimum assistant surgeon | Use when a minimum assistant is required and meets payer rules. |
TC | Technical component | Use when reporting only the technical component of the service when applicable (facility billing). |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | Use when an assistant at surgery provided by an advanced practice clinician meets payer requirements. |
22 | Increased procedural services | Use when work required to perform the procedure is substantially greater than typically required. |
23 | Unusual anesthesia | Use when general anesthesia is required for a procedure that normally uses local anesthesia or moderate sedation. |
52 | Reduced services | Use when the procedure is partially performed or truncated (listed again for emphasis if applicable). |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RP0000X | Pulmonology | Pulmonologists commonly perform bronchoscopic brush biopsies. |
| 2084P0800X | Thoracic Surgery | Thoracic surgeons perform airway biopsies in the OR for complex cases. |
| 363LP0200X | Interventional Pulmonology | Interventional pulmonologists perform advanced airway sampling and therapeutic bronchoscopy. |
| 207L00000X | Critical Care Medicine | Intensivists perform bronchoscopic sampling in the ICU setting. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
C34.90 | Malignant neoplasm of unspecified bronchus or lung, unspecified side | Central or endobronchial lung tumors frequently warrant brush biopsy for cytologic evaluation. |
R04.2 | Hemoptysis, unspecified | Unexplained hemoptysis prompts bronchoscopic evaluation with brushings to identify bleeding source or malignancy. |
R05 | Cough | Persistent unexplained cough with imaging findings may lead to bronchoscopic brush sampling. |
J98.4 | Other disorders of lung, not elsewhere classified | Atypical airway lesions or suspected infection/inflammation requiring cytologic sampling. |
J84.10 | Pulmonary fibrosis, unspecified | When progressive interstitial disease has focal endobronchial abnormalities, brushings can assist with evaluation. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
31622 | Bronchoscopy, rigid or flexible, diagnostic, with or without collection of specimen(s) by brushing or washing, with or without bronchial or endobronchial biopsy | Often performed immediately before or during which 31717 brush catheter sampling may be obtained; provides airway access and visualization. |
31623 | Bronchoscopy, with bronchial or endobronchial biopsy | Forceps biopsy that commonly complements brush biopsy (31717) to obtain tissue cores for histology. |
31624 | Bronchoscopy, with transbronchial lung biopsy(s) | Performed when parenchymal tissue is required in addition to brush cytology for diagnosis. |
31628 | Bronchoscopy, with transbronchial lung biopsy(s), with fluoroscopic guidance | Used when transbronchial biopsies are performed with imaging guidance in the same session as brush biopsy. |
31652 | Bronchoscopy, with removal of foreign body, tumor, or other obstruction by snare or forceps | Therapeutic procedures that may be performed in the same session if brush biopsy reveals obstructing lesion requiring removal. |