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A bronchoplasty is a surgical procedure aimed at repairing the bronchus, which is the airway that leads from the trachea to the lungs. The specific procedure described by CPT® Code 31770 involves the use of a graft to repair the bronchus. This is typically indicated in cases where there is damage or a defect in the bronchial structure that requires surgical intervention. The procedure begins with an anterior intercostal incision, which is extended around the chest to the scapula, allowing for adequate exposure of the lung and bronchus. A rib spreader may be utilized to facilitate access, and in some instances, a rib may be removed to enhance visibility and access to the bronchus. Once the lung is deflated, the bronchus is carefully exposed for repair. The graft repair often employs a pericardial patch, which is a section of the pericardium, the membrane surrounding the heart. This patch is excised, treated with glutaraldehyde solution for preservation, and then configured to fit the defect in the bronchus. The procedure requires meticulous attention to detail, including the identification and protection of the phrenic nerve, which is crucial for diaphragm function. The graft is then sutured to the bronchial defect, and the pericardial site is closed. This procedure is critical for restoring airway integrity and function, ensuring that the patient can breathe effectively post-surgery.
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The bronchoplasty with graft repair (CPT® Code 31770) is indicated for patients who present with bronchial defects that may arise from various conditions, including but not limited to:
The procedure for bronchoplasty with graft repair involves several critical steps to ensure successful repair of the bronchus:
After the bronchoplasty with graft repair is completed, several post-procedure care steps are essential for patient recovery. Saline solution is instilled into the pleural cavity to help re-expand the lung. The graft or anastomosis site is carefully checked for any air leaks to ensure proper healing and function. Chest tubes may be placed as needed to facilitate drainage and prevent fluid accumulation. Finally, the chest incisions are closed in layers to promote optimal healing. Patients will be monitored closely during the recovery period to assess lung function and overall recovery.
| Short Descr | REPAIR/GRAFT OF BRONCHUS | Medium Descr | BRONCHOPLASTY GRAFT REPAIR | Long Descr | Bronchoplasty; graft repair | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard 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) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 2 | CCS Clinical Classification | 42 - Other OR therapeutic procedures on respiratory system |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| Pre-1990 | Added | Code added. |
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