Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with brushing or protected brushings
CPT4 code
Name of the Procedure:
Bronchoscopy, Rigid or Flexible, including Fluoroscopic Guidance, when Performed; with Brushing or Protected Brushings
Summary
Bronchoscopy is a medical procedure that involves inserting a thin, flexible tube or a rigid scope through the mouth or nose and into the lungs. The procedure allows doctors to view the airways and collect samples using a brushing technique, often guided by fluoroscopy for better accuracy.
Purpose
Bronchoscopy helps diagnose and treat conditions affecting the airways and lungs. Its goals can include identifying infections, inflammation, or cancer, and assessing blockages or structural abnormalities in the airways.
Indications
- Persistent cough
- Unexplained lung issues
- Suspicion of lung infections or tumors
- Detection and evaluation of abnormal chest x-rays or CT scans
- Persistent lung inflammation or bleeding
Preparation
- Fast for six to eight hours prior to the procedure
- Adjust or stop certain medications, as advised by the doctor
- Undergo pre-procedure tests such as blood tests or imaging studies
- Arrange for someone to drive you home post-procedure
Procedure Description
- You will be given a sedative or anesthesia.
- A local anesthetic may be applied to your nose or throat.
- The bronchoscope, either flexible or rigid, is inserted through the nose or mouth.
- Fluoroscopic guidance may be used for precise visualization.
- Brushing or protected brushing is performed to collect cell samples from the airways.
- The samples are sent to a lab for analysis.
- The bronchoscope is carefully removed.
Duration
The procedure typically takes about 30 to 60 minutes.
Setting
Bronchoscopy is usually performed in a hospital, outpatient clinic, or a specialized surgical center.
Personnel
- Pulmonologist or thoracic surgeon
- Nurses
- Anesthesiologists (if general anesthesia is used)
- Radiologic technologist (for fluoroscopic guidance)
Risks and Complications
- Sore throat or hoarseness
- Bleeding from biopsy sites
- Infection
- Pneumothorax (collapsed lung)
- Adverse reaction to sedation or anesthesia
Benefits
- Accurate diagnosis of lung and airway conditions
- Direct visualization of abnormalities
- Effective sample collection for laboratory analysis
- Potential for immediate therapeutic interventions if necessary
Recovery
- Monitor in a recovery area until the effects of sedation wear off
- Avoid eating or drinking until sensation returns to the throat (1-2 hours)
- Follow guidance on resuming normal activities and medications
- Schedule follow-up appointments for results and further care
Alternatives
- Chest x-ray or CT scan: less invasive but less detailed
- Sputum cytology: non-invasive sample collection from mucus but may be less diagnostic
- Surgical biopsy: more invasive, requires longer recovery time
Patient Experience
During the procedure, you may experience mild discomfort but sedation usually prevents significant pain. After the procedure, you might have a mild sore throat and feel tired. Pain management and comfort measures include throat lozenges, gargling with warm salt water, and over-the-counter pain relievers.