Summary & Overview
CPT 32997: Therapeutic Bronchoscopic Lung Lavage
CPT code 32997 identifies a therapeutic bronchoscopic lung lavage procedure in which the lung is irrigated with saline under bronchoscopic guidance to remove secretions or pathological material. Nationally, this procedure matters for acute respiratory care pathways, critical care management, and hospital-based bronchoscopy services because it is performed for a range of respiratory conditions that require direct airway clearance and targeted removal of material not amenable to suctioning alone. Payers commonly covering or adjudicating claims for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find clinical and billing context for when CPT code 32997 is used, typical sites of service, and how the procedure fits into hospital-based respiratory care. The publication provides benchmarks and claims patterns where available, notes on payer coverage considerations, and policy-related updates that affect coding and reimbursement for bronchoscopic therapeutic interventions. The content is designed to support coding accuracy, payer communication, and operational planning for facilities that perform bronchoscopy and therapeutic lung lavage. Data not available in the input will be identified as such in the relevant sections.
Billing Code Overview
CPT code 32997 describes a therapeutic pulmonary lavage procedure in which the provider irrigates and washes out the lung using sterile saline with the assistance of bronchoscopy. The procedure is intended to remove debris, secretions, or pathological material from the bronchial tree and alveolar spaces through direct visualization.
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Service type: Therapeutic bronchoscopic lung lavage
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Typical site of service: Hospital inpatient or hospital outpatient department; may also be performed in an endoscopy or bronchoscopy suite equipped for bronchoscopic procedures.
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting with persistent pulmonary infection, thick mucus plugging, or suspected retained bronchial secretions after pulmonary aspiration. The patient has progressive hypoxemia, fever, or radiographic lobar collapse despite medical therapy. The pulmonologist determines that bronchoscopic saline lavage is required to remove inspissated secretions, obtain therapeutic clearance, and collect specimens for culture. The procedure is performed under moderate sedation or general anesthesia in an operating room or bronchoscopy suite with continuous monitoring. A flexible bronchoscope is inserted via the endotracheal tube or through the mouth/nose for non-intubated patients. Warmed sterile saline is instilled into the targeted bronchopulmonary segment and then suctioned to wash out mucus, debris, or contaminants. Clinical workflow includes pre-procedure informed consent, review of coagulation status and chest imaging, sedation and airway management, bronchoscopy with lavage and specimen collection, post-procedure monitoring for oxygenation and bleeding, and documentation of indications, findings, volume of lavage fluid, specimens obtained, and any complications. Common clinical settings include inpatient critical care, emergency department with airway compromise, and outpatient bronchoscopy suites for recurrent lobar collapse or diagnostic lavage.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal or usual provider service | Use when this is the primary, expected service provided by the operating clinician without unusual circumstances |