Summary & Overview
HCPCS C7567: Bronchoscopy with Image-Guided Transbronchial Needle Aspiration
HCPCS Level II code C7567 denotes a bronchoscopy procedure—rigid or flexible—with transbronchial needle aspiration (TBNA) of the trachea, mainstem or lobar bronchi, performed with fluoroscopic guidance when indicated and augmented by computer-assisted image-guided navigation. The code captures a complex, image-guided interventional pulmonary service used for diagnostic sampling of central airway and peribronchial lesions. Nationally, this procedure matters because it supports minimally invasive diagnosis and staging for lung and airway pathologies while reducing the need for more invasive surgical biopsies.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn the clinical context for use of C7567, expected sites of service, and what elements define billing for this image-guided TBNA bronchoscopy. The publication provides benchmarks and coding guidance around when navigation and fluoroscopic guidance are integral to the billed service, summaries of payer coverage patterns where available, and relevant policy or reimbursement updates that affect national practice. Clinical implications, resource and equipment considerations, and typical care pathways tied to this procedure are summarized to help coding, billing, and clinical teams align documentation to the coded service.
Data not available in the input: common modifiers, associated taxonomies, specific ICD-10 diagnoses, related codes, and detailed payer policy language.
Billing Code Overview
HCPCS Level II code C7567 describes a bronchoscopy, rigid or flexible, including fluoroscopic guidance when performed, with transbronchial needle aspiration biopsy(s) of the trachea, main stem and/or lobar bronchus, with computer-assisted image-guided navigation. This procedure combines endoscopic airway visualization and tissue sampling using needle aspiration, augmented by fluoroscopy and computer-assisted navigation to improve targeting.
Service type: Interventional pulmonary procedure with image-guided transbronchial needle aspiration
Typical site of service: Hospital operating room or procedure suite, ambulatory surgery center, or dedicated bronchoscopy suite
Clinical & Coding Specifications
Clinical Context
A 62-year-old male with a 40-pack-year smoking history presents with a 3-week history of persistent cough, hemoptysis, and an enlarging 3-cm right upper lobe pulmonary nodule on chest CT. PET-CT shows increased FDG uptake in the lesion and mediastinal lymph nodes. Pulmonology schedules a diagnostic bronchoscopy with computer-assisted electromagnetic navigation to reach the peripheral lesion. Under general anesthesia in the bronchoscopy suite with fluoroscopic guidance, the team performs a flexible bronchoscopy with transbronchial needle aspiration (TBNA) of the right mainstem and lobar bronchus and targeted sampling of the peripheral nodule using image-guided navigation. Specimens are submitted for cytology, histology, and molecular testing. Postprocedure recovery includes monitoring for bleeding and pneumothorax, with a chest radiograph obtained prior to discharge.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the day of a procedure | When a separate E/M visit is documented on the same day as the bronchoscopy (distinct history/exam/medical decision-making) |
59 | Distinct procedural service |