Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), each additional lobe (List separately in addition to code for primary procedure)
CPT4 code
Name of the Procedure:
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), each additional lobe.
Summary
A bronchoscopy is a procedure that allows doctors to look inside the lungs using a thin, flexible tube equipped with a camera. Fluoroscopic guidance may be used to enhance imaging. This specific procedure involves taking needle biopsy samples from multiple lobes of the lung.
Purpose
The bronchoscopy is primarily used to diagnose lung diseases, infections, or cancer by collecting tissue samples (biopsies) from different parts of the lung. The goal is to obtain accurate diagnostic information, guide treatment plans, and monitor disease progress.
Indications
- Persistent cough or hemoptysis (coughing up blood)
- Abnormal chest x-rays or CT scans
- Suspected lung infections or cancers
- Unexplained lung nodules or masses
- Difficulty breathing not explained by other tests
Preparation
- Patients may need to fast for several hours before the procedure.
- Blood tests, chest x-rays, or CT scans might be required.
- Avoid certain medications (e.g., blood thinners) as advised by the healthcare provider.
Procedure Description
- The patient will be given anesthesia or sedation.
- The flexible or rigid bronchoscope is inserted through the mouth or nose into the airways.
- Fluoroscopic imaging is used to help navigate and visualize the bronchi.
- A needle aspiration biopsy is performed to collect tissue samples from different lobes of the lung.
- The samples are sent to a lab for analysis, and the scope is carefully removed.
Duration
The procedure typically takes between 30 minutes to an hour.
Setting
The procedure is usually performed in a hospital, often in a specialized endoscopy or surgery unit.
Personnel
- Pulmonologist or thoracic surgeon
- Nurses
- Anesthesiologist or nurse anesthetist
- Radiology technician (for fluoroscopic guidance)
Risks and Complications
- Bleeding from biopsy sites
- Infection
- Pneumothorax (collapsed lung)
- Reactions to anesthesia
- Sore throat or hoarseness
Benefits
- Accurate diagnosis of lung conditions
- Minimally invasive compared to surgical biopsies
- Quick recovery time
- Provides clear guidance for treatment plans
Recovery
- Patients are monitored for a few hours post-procedure but often go home the same day.
- Rest and avoid strenuous activities for 24-48 hours.
- Follow-up appointments may be necessary to discuss biopsy results.
Alternatives
- Non-invasive imaging tests (e.g., CT or MRI scans)
- Surgical lung biopsy (more invasive but may be necessary if bronchoscopy is inconclusive)
- Observation and follow-up imaging if immediate biopsy is not critical
Patient Experience
During the procedure, the patient may experience mild discomfort and a sensation of pressure but should not feel pain due to anesthesia or sedation. Post-procedure, they may have a sore throat or cough. Pain management strategies and comfort measures will be provided by the healthcare team.