This document addresses the use of navigational bronchoscopy (NB) devices as an aid in accessing peripheral lung lesions and masses, which may be inaccessible by standard bronchoscopy. This document includes the following techniques:

• Electromagnetic navigational bronchoscopy (ENB)
• Artificial Intelligence (AI) Tomography with Augmented Fluoroscopic Guidance 
• Robotic assisted bronchoscopy

Navigational bronchoscopy has also been used as a means of placing fiducial markers for surgical and radiological procedures.

Clinical Indications

Medically Necessary:

Navigational bronchoscopy is considered medically necessary for the following indications (A or B):

1. In individuals for whom nonsurgical biopsy is indicated when both transthoracic needle biopsy and conventional bronchoscopy are considered inadequate to accomplish the diagnostic or interventional objective; or
2. For the pre-treatment placement of fiducial markers within lung tumor(s).

Not Medically Necessary:

Navigational bronchoscopy is considered not medically necessary for all other indications.