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Bronchial thermoplasty is a medical procedure designed to manage severe, persistent asthma in patients whose symptoms are not adequately controlled by standard inhaled corticosteroids and long-acting beta-agonists. This procedure involves the use of a bronchoscope, which can be either rigid or flexible, to access the airways. The bronchoscope is introduced through the patient's nose or mouth and navigated into the oropharynx, with fluoroscopic guidance utilized as necessary to ensure accurate placement. Once the bronchoscope reaches the trachea, it is further advanced into either the right or left mainstem bronchus. During this process, any abnormalities within the airways are carefully noted. If a rigid bronchoscope is employed, a telescope or flexible bronchoscope may be inserted through it to allow for visualization of the distal segments of each mainstem bronchus. The procedure specifically targets the airway walls, where a catheter containing a thermoplasty device is introduced and positioned at the first treatment site, typically the most distal airway within the targeted lobe. An electrode array is then placed against the airway wall, and the device is activated to deliver low-power, temperature-controlled radiofrequency (RF) energy for a maximum duration of 10 seconds at each targeted location. This RF energy effectively heats and destroys excessive smooth muscle tissue in the airway, which can restrict the airway's ability to contract. The electrodes are systematically repositioned and activated along all accessible airways distal to the mainstem bronchus within the lobe being treated. It is important to note that for the treatment of one lobe in a single session, the appropriate code to use is 0276T, while for the treatment of two or more lobes in a single session, the code 0277T should be utilized. Typically, multiple bronchial thermoplasty sessions are necessary, as only a limited portion of the lungs (1-2 lobes) can be treated during each session.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure of bronchial thermoplasty is indicated for patients with severe, persistent asthma that remains poorly controlled despite the use of inhaled corticosteroids and long-acting beta-agonists. This treatment is specifically aimed at reducing asthma symptoms and improving overall respiratory function in individuals who experience significant limitations in their daily activities due to their condition.
The bronchial thermoplasty procedure involves several key steps to ensure effective treatment of the targeted airway. First, a bronchoscope, which can be either rigid or flexible, is introduced through the patient's nose or mouth. The bronchoscope is then advanced into the oropharynx, and fluoroscopic guidance may be utilized to assist in navigating the airway accurately. Once the bronchoscope reaches the trachea, it is further advanced into either the right or left mainstem bronchus. During this process, the physician carefully observes and notes any abnormalities present in the airways. If a rigid bronchoscope is used, a telescope or flexible bronchoscope may be inserted through it to visualize the distal segments of each mainstem bronchus more effectively. Following this, a catheter containing the thermoplasty device is introduced through the bronchoscope and positioned at the first target treatment site, which is typically the most distal airway within the lobe being treated. An electrode array is then placed against the wall of the airway, and the thermoplasty device is activated to deliver low-power, temperature-controlled radiofrequency (RF) energy to the airway wall for a maximum of 10 seconds at each targeted location. This RF energy serves to heat the airway wall, effectively destroying excessive smooth muscle tissue that can limit the airway's ability to contract. After the initial treatment, the electrodes are repositioned and activated along all accessible airways distal to the mainstem bronchus within the lobe being treated, ensuring comprehensive treatment of the affected area.
After the bronchial thermoplasty procedure, patients may experience some degree of discomfort or transient respiratory symptoms, which are typically manageable. It is essential for healthcare providers to monitor patients for any immediate post-procedure complications. Patients may require follow-up visits to assess their response to the treatment and to determine if additional sessions are necessary, as bronchial thermoplasty is usually performed in multiple sessions to treat 1-2 lobes at a time. The overall recovery process may vary depending on the individual patient's condition and the extent of the treatment performed.
| Short Descr | BRONCH THERMOPLASTY 1 LOBE | Medium Descr | BRONCHSCPY FLUORO W/BRONCHIAL THERMPLASTY 1 LOBE | Long Descr | Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 1 lobe | Status Code | Carriers Price the Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Discontinued Code | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | none | MUE | Not applicable/unspecified. | CCS Clinical Classification | 42 - Other OR therapeutic procedures on respiratory system |
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