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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 the right or left mainstem bronchus, allowing for a thorough examination of the airways for any abnormalities. In cases where a rigid bronchoscope is employed, a telescope or flexible bronchoscope may be inserted through it to visualize the distal segments of each mainstem bronchus effectively. The procedure specifically targets the excessive smooth muscle tissue in the airways, which can contribute to airway constriction and asthma symptoms. By delivering controlled radiofrequency energy to the airway walls, bronchial thermoplasty aims to reduce the amount of smooth muscle, thereby improving airway function and reducing asthma exacerbations. It is important to note that this procedure is typically performed in multiple sessions, as only a limited number of lobes (1-2) can be treated during each session, with CPT® Code 0277T specifically indicating the treatment of two or more lobes in a single 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 individuals who experience significant asthma symptoms and exacerbations, which can severely impact their quality of life and daily functioning.
The bronchial thermoplasty procedure involves several key steps to ensure effective treatment. 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 the right or left mainstem bronchus. During this process, any abnormalities within the airways are carefully noted. 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, allowing for a comprehensive assessment of the airways.
After the bronchoscope is properly positioned, 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 in the targeted lobe. An electrode array is then placed against the wall of the airway. The device is activated, delivering low-power, temperature-controlled radiofrequency (RF) energy to the airway wall for a maximum of 10 seconds at each location. This RF energy effectively heats the airway wall, destroying excessive smooth muscle tissue that can restrict airway contraction. Following the initial treatment, the electrodes are 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, CPT® Code 0276T should be used, while CPT® Code 0277T is designated for the treatment of two or more lobes in a single session. Typically, multiple bronchial thermoplasty sessions are required to achieve optimal results, as only a portion of the lungs (1-2 lobes) can be treated during each session.
After the bronchial thermoplasty procedure, patients may experience some post-procedure care considerations. It is common for patients to have a recovery period during which they may be monitored for any immediate complications or adverse reactions. Patients are typically advised to follow up with their healthcare provider to assess the effectiveness of the treatment and to discuss any ongoing management of their asthma symptoms. Additionally, it is important for patients to adhere to any prescribed medication regimens and to maintain regular check-ups to ensure optimal asthma control following the procedure.
| Short Descr | BRONCH THERMOPLASTY LOBES | Medium Descr | BRONCHSCPY FLUORO W/BRNCHIAL THERMPLASTY />2LOBE | Long Descr | Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 2 or more lobes | 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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