CPT® Code 71040

Deleted

1. Indications

Bronchography is indicated for the evaluation of various conditions affecting the lower respiratory tract. The following are specific indications for performing this procedure:

• Assessment of Abnormalities This procedure is utilized to investigate structural abnormalities within the larynx, trachea, and bronchi, which may include tumors, strictures, or foreign bodies.
• Evaluation of Infections Bronchography can help in assessing the extent of infections in the lower respiratory tract, such as bronchitis or pneumonia, by providing detailed images of the affected areas.
• Preoperative Planning It may be performed as part of the preoperative assessment for patients undergoing surgical procedures involving the respiratory system, allowing for better surgical planning.
• Investigation of Hemoptysis The procedure is also indicated for patients presenting with hemoptysis (coughing up blood) to identify potential sources of bleeding within the bronchial tree.

2. Procedure

The bronchography procedure involves several critical steps to ensure accurate imaging of the lower respiratory tract. The following outlines the procedural steps:

• Step 1: Patient Preparation The patient is positioned appropriately, typically in a supine position, to facilitate access to the airway. Pre-procedural assessments are conducted to ensure the patient is fit for the procedure, and informed consent is obtained.
• Step 2: Anesthesia Administration Local anesthesia may be administered to minimize discomfort during the procedure. In some cases, sedation may also be provided to help the patient relax.
• Step 3: Catheter or Bronchoscope Insertion A catheter or bronchoscope is carefully inserted through the patient's nose or mouth, advancing it through the throat and into the trachea and bronchi. This step requires precision to avoid injury to the surrounding structures.
• Step 4: Contrast Injection Once the catheter or bronchoscope is in place, a contrast medium is injected. This contrast agent coats the lining of the lower respiratory tract, enhancing the visibility of the structures during imaging.
• Step 5: Radiological Supervision The physician supervises the radiological component of the procedure, ensuring that radiographs are obtained at appropriate intervals as the contrast is distributed throughout the bronchial tree.
• Step 6: Image Acquisition Radiographs are taken to capture detailed images of the lower respiratory tract. The physician monitors the imaging process to ensure optimal quality and coverage of the area of interest.
• Step 7: Post-Procedure Review After the imaging is completed, the physician reviews the radiographs and prepares a written interpretation of the findings, which is essential for further clinical decision-making.

3. Post-Procedure

Following the bronchography procedure, patients are typically monitored for any immediate adverse reactions to the contrast medium or anesthesia. It is important to assess the patient's respiratory status and ensure that they are stable before discharge. Patients may experience mild discomfort or a sore throat due to the insertion of the catheter or bronchoscope, which usually resolves quickly. Instructions regarding post-procedure care, including any restrictions on activities and signs of complications to watch for, should be provided. The physician's written interpretation of the radiographs will be communicated to the patient and relevant healthcare providers to guide further management and treatment decisions.