Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with computer-assisted, image-guided navigation (List separately in addition to code for primary procedure[s])
CPT4 code
Name of the Procedure:
Bronchoscopy, Rigid or Flexible, Including Fluoroscopic Guidance, when Performed; with Computer-Assisted, Image-Guided Navigation
Summary
Bronchoscopy is a medical procedure that allows doctors to examine the inside of the lungs and air passages. This is done using a thin tube called a bronchoscope, which can be either rigid or flexible. The procedure may also involve fluoroscopic guidance and advanced computer-assisted, image-guided navigation to enhance accuracy.
Purpose
Bronchoscopy helps diagnose lung diseases, infections, tumors, and other respiratory issues. The primary goals are to obtain tissue samples, clear blockages, and assess abnormalities, ensuring a precise diagnosis and enabling targeted treatment.
Indications
- Persistent cough
- Unexplained or recurrent lung infections
- Abnormal chest X-ray or CT scan findings
- Suspected lung cancer
- Hemoptysis (coughing up blood)
- Foreign body retrieval
- Assessment before lung surgery
Preparation
- Fasting for 6-12 hours prior to the procedure
- Medication adjustments as advised by the doctor
- Pre-procedural diagnostic tests such as blood work, chest X-ray or CT scan
- Provision of informed consent
Procedure Description
- Anesthesia: Local anesthesia to numb the throat, with possible sedation or general anesthesia.
- Insertion: The bronchoscope is inserted through the mouth or nose into the windpipe.
- Navigation: Computer-assisted, image-guided navigation is used to guide the bronchoscope precisely.
- Assessment: Inspection of the airways and collection of tissue samples if needed.
- Fluoroscopy: Real-time X-ray imaging helps in positioning and maneuvering the bronchoscope.
Duration
The procedure typically takes between 30 minutes to 2 hours, depending on its complexity.
Setting
Bronchoscopy is usually performed in a hospital's endoscopy suite or operating room.
Personnel
- Pulmonologist or thoracic surgeon
- Anesthesiologist (if general anesthesia is used)
- Trained nurses and respiratory therapists
- Radiology technician for fluoroscopic guidance
Risks and Complications
- Bleeding
- Infection
- Pneumothorax (collapsed lung)
- Bronchospasm
- Adverse reactions to sedation or anesthesia
Benefits
- Accurate diagnosis of lung conditions
- Targeted treatment or intervention
- Minimally invasive with quick recovery
- Immediate relief if foreign body removal or blockage clearance is performed
Recovery
- Observation in a recovery area for a few hours
- Sore throat and hoarseness for a few days
- Avoiding strenuous activities for 24 hours
- Follow-up appointments to discuss findings and further treatment
Alternatives
- Chest X-ray or CT scan: Less invasive but less detailed
- Sputum cytology: Examination of mucus, less accurate
- Needle biopsy: Minimally invasive but not suitable for all areas
- Surgical biopsy: More invasive with longer recovery
Patient Experience
- Sedation will reduce discomfort but mild soreness and coughing are common post-procedure.
- Pain management through prescribed medications, if needed.
- Patients may feel drowsy until the anesthesia effects wear off completely.
- Clear communication with the healthcare team regarding pain and discomfort ensures better care and comfort.