Ambu 4 aScope Broncho Regular User Guide

Ambu 4 aScope Broncho Regular User Guide

About the aScope™ Broncho

aScope Broncho endoscopes are single-use, sterile, flexible video bronchoscopes that offer an intuitive, lightweight design with similar functionality to reusable bronchoscopes. The aScope Broncho family of products is designed for use in upper airway endoscopy, capable of performing both diagnostic and therapeutic procedures. aScope 4 Broncho models are compatible with the aView™ 2 Advance HD monitor while the aScope 5 Broncho is compatible with the aView 2 Advance HD monitor and the new Ambu aBox™ 2.

Transitional Pass-Through Payment (TPT) was awarded to the aScope 5 Broncho HD effective 01/01/2024. TPT payments are intended to facilitate Medicare beneficiary access to the benefits of new and innovative medical devices, drugs, and biologicals that demonstrate a substantial clinical improvement over existing technology and will remain in effect for 2 to 3 years. HCPCS/CPT Code C1601 was awarded only to aScope 5 Broncho HD and must be included on the claim to receive TPT payments. For further information, visit our aScope 5 TPT page: https://www.ambuusa.com/ascope5- broncho-tpt-payments

C1601| Endoscope, single-use (i.e. disposable, pulmonary, imaging/illumination device (insertable)
---|---

*The 2024 CMS CPT Code device offset amounts associated with C1601 can be found on pages 9-10.

HOSPITAL OUTPATIENT, AMBULATORY SURGICAL CENTER, AND PHYSICIAN OFFICE

CODING AND PAYMENT

The table below provides an overview of potential procedural codes and the associated Medicare national payment rates when aScope Broncho endoscopes are used in hospital outpatient departments (HOPDs; places of service 19 and 22), ambulatory surgical centers (ASCs; place of service 24), and physician offices (place of service 11). The physician relative value units (RVUs) for the procedures below are listed on pages 7-8. Place of service definitions are provided on page 11.

CPT Codes and 2024 Medicare National Payment Rates for Bronchoscopy Procedures

CPT®

Code1

| ****

CPT Long Descriptor

| Physician Service Payment2| Facility Payment3
---|---|---|---
Non- Facility (clinic)| ****

Facility

| ****

APC

| HOPD

Payment

| ****

ASC

31615| Tracheobronchoscopy through established tracheostomy incision| $169.62| $113.30| 5162| $524.23| $285.42
31622| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with cell washing| $244.93| $127.70| 5153| 1,617.14| $757.16
31623| Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with brushing or protected brushings| $268.83| $126.72| 5153| $1,617.14| $757.16
31624| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with broncheal alveolar lavage| $250.17| $128.36| 5153| $1,617.14| $757.16
31625| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with bronchial or endobronchial biopsy(s), single or multiple sites| $341.52| $149.97| 5153| $1,617.14| $757.16
31626| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with placement of fiducial markers, single or multiple| $767.52| $189.26| 5155| 6,521.19| $2,301.13
31627| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with computer- assisted, image-guided navigation| $1,041.59| $92.34| 0| N/A| $0.00
31628| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with transbronchial lung biopsy(s), single lobe| $363.79| $168.63| 5154| $3,568.05| $1,566.67

CPT®

Code1

| ****

CPT Long Descriptor

| Physician Service Payment2| Facility Payment3
---|---|---|---
Non- Facility (clinic)| ****

Facility

| ****

APC

| HOPD

Payment

| ****

ASC

31629| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i)| $442.70| $179.11| 5154| $3,568.05| $1,566.67
31630| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with tracheal/ bronchial dilation or closed reduction of fracture| N/A| $190.57| 5154| $3,568.05| $1,566.67
31631| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with placement of tracheal stent(s) (includes tracheal/bronchial dilation as required| N/A| $217.09| 5155| $6,521.19| $2,301.13
31632| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with transbronchial lung biopsy(s), each additional lobe (list separately in addition to code for primary procedure)| $63.20| $46.82| 0| $-| $0.00
31633| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with transbronchial needle aspiration biopsy(s), each additional lobe (list separately in addition to code for primary procedure)| $78.59| $60.25| 0| $-| $0.00
31634| Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, with assessment of air leak, with administration of occlusive substance (eg, fibrin glue), if performed| $1,434.85| $180.42| 5155| $6,521.19| $2,301.13
31635| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with removal of foreign body| $287.17| $168.63| 5153| $1,617.14| $757.16
31636| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with placement of bronchial stent(s)(includes tracheal/bronchial dilation as required), initial bronchus| NA| $207.60| 5155| $6,521.19| $3,078.65
31637| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, each additional major bronchus stented (list separately in addition to code for primary procedure)| NA| $72.69| 0| $-| $0.00
31638| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with revision of tracheal or bronchial stent insreted at previous session (includes tracheal/bronchial dilation as required)| NA| $235.76| 5155| $6,521.19| $2,301.13
31640| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with excision of tumor| NA| $237.07| 5154| $3,568.05| $1,566.67
31641| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with destruction of tumor or relief of stenosis by any method other than excision (eg laser therapy, cryotherapy)| NA| $243.62| 5154| $3,568.05| $1,566.67
31643| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with placement of catheter(s) for intracavitary radioelement application| NA| $162.41| 5153| $1,617.14| $757.16
31645| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with therapeutic aspiration of tracheobronchial tree, initial| $268.83| $141.46| 5153| $1,617.14| $757.16

CPT®

Code1

| ****

CPT Long Descriptor

| Physician Service Payment2| Facility Payment3
---|---|---|---
Non- Facility (clinic)| ****

Facility

| ****

APC

| HOPD

Payment

| ****

ASC

31646| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with therapeutic aspiration of tracheobronchial tree, subsequent, sams hospital stay| NA| $136.54| 5152| $389.05| $211.82
31647| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), initial lobe| NA| $196.79| 5155| $6,521.19| $2,899.76
31648| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with removal of bronchial valve(s), initial lobe| NA| $189.92| 5154| $3,568.05| $1,566.67
31649| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with removal of bronchial valve(s), each additional lobe (list separately in addition to code for primary procedure)| $63.85| $63.85| 5153| 1,617.14| $757.16
31652| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration(s)/biopsy[ies]),

one or two mediastinal and/or hilar lymph node stations or structures

| $1,214.81| $211.20| 5154| $3,568.05| $1,566.67
31653| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration(s)/biopsy[ies]), 3

or more mediastinal and/or hilar lymph node stations or structures

| $1,260.98| $234.12| 5154| $3,568.05| $1,566.67
31654| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with endobronchial ultrasound (EBUS) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion(s)| $117.88| $64.18| 0| N/A| N/A
31660| Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 1 lobe| NA| $181.73| 5155| $6,521.19| ASC

excluded

31661| Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 2 or more lobes| NA| $191.88| 5155| $6,521.19| ASC

excluded

31780| Excision tracheal stenosis and anastomosis; cervical| NA| $1,178.14| Inpatient Only
31781| Excision tracheal stenosis and anastomosis; cervicothoracic| NA| $1,410.62| Inpatient Only
31785| Excision of tracheal tumor or carcinoma; cervical| NA| $1,055.02| 5165| $5,165.00| ASC

excluded

CPT®

Code1

| ****

CPT Long Descriptor

| Physician Service Payment2| Facility Payment3
---|---|---|---
Non- Facility (clinic)| ****

Facility

| ****

APC

| HOPD

Payment

| ****

ASC

31786| Excision of tracheal tumor or carcinoma; thoracic| NA| $1,395.23| Inpatient Only
32200| Pneumonostomy, with open drainage of abscess or cyst| NA| $1,109.70| Inpatient Only
32400| Biopsy, pleura, percutaneous needle| $165.03| $80.55| 5072| $1,544.75| $682.92
32550| Insertion of indwelling tunneled pleural catheter with cuff| $754.43| $196.47| 5341| $3,296.34| $2,121.29
32551| Tube thoracostomy, includes connection to drainage system (eg, water seal), when performed, open (separate procedure)| NA| $150.30| 5182| $1,525.93| ASC

excluded

32552| Removal of indwelling tunneled pleural catheter with cuff| $178.78| $152.59| 5181| $598.55| $325.88
32554| Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance| $229.54| $85.46| 5181| $598.55| $325.88
32674| Thoracoscopy, surgical; with mediastinal and regional lymphadenectomy (List separately in addition to code for primary procedure)| NA| $206.62| Inpatient Only

Inpatient Codes

Endoscopic, Diagnostic
0B9J8ZX| Drainage of Left Lower Lung Lobe, Via Natural or Artificial Opening Endoscopic, Diagnostic
0B9D8ZX| Drainage of Right Middle Lung Lobe, Via Natural or Artificial Opening Endoscopic, Diagnostic
0B9C8ZX| Drainage of Right Upper Lung Lobe, Via Natural or Artificial Opening Endoscopic, Diagnostic
07B74ZX| Excision of Thorax Lymphatic, Percutaneous Endoscopic Approach, Diagnostic
0B9G8ZX| Drainage of Left Upper Lung Lobe, Via Natural or Artificial Opening Endoscopic, Diagnostic
0B9H8ZX| Drainage of Lung Lingula, Via Natural or Artificial Opening Endoscopic, Diagnostic
0B9M8ZX| Drainage of Bilateral Lungs, Via Natural or Artificial Opening Endoscopic, Diagnostic
0BBF8ZX| Excision of Right Lower Lung Lobe, Via Natural or Artificial Opening Endoscopic, Diagnostic
0BBC8ZX| Excision of Right Upper Lung Lobe, Via Natural or Artificial Opening Endoscopic, Diagnostic
0BBJ8ZX| Excision of Left Lower Lung Lobe, Via Natural or Artificial Opening Endoscopic, Diagnostic
0BBG8ZX| Excision of Left Upper Lung Lobe, Via Natural or Artificial Opening Endoscopic, Diagnostic
0B9L8ZX| Drainage of Left Lung, Via Natural or Artificial Opening Endoscopic, Diagnostic
0B9K8ZX| Drainage of Right Lung, Via Natural or Artificial Opening Endoscopic, Diagnostic
0BBD8ZX| Excision of Right Middle Lung Lobe, Via Natural or Artificial Opening Endoscopic, Diagnostic
0WHQ7YZ| Insertion of Other Device into Respiratory Tract, Via Natural or Artificial Opening
0BBH8ZX| Excision of Lung Lingula, Via Natural or Artificial Opening Endoscopic, Diagnostic
0BBK8ZX| Excision of Right Lung, Via Natural or Artificial Opening Endoscopic, Diagnostic
0BBL8ZX| Excision of Left Lung, Via Natural or Artificial Opening Endoscopic, Diagnostic
4A07X7Z| Measurement of Visual Mobility, External Approach
0BBM8ZX| Excision of Bilateral Lungs, Via Natural or Artificial Opening Endoscopic, Diagnostic
0BBG7ZX| Excision of Left Upper Lung Lobe, Via Natural or Artificial Opening, Diagnostic
0BBF7ZX| Excision of Right Lower Lung Lobe, Via Natural or Artificial Opening, Diagnostic
0BBC7ZX| Excision of Right Upper Lung Lobe, Via Natural or Artificial Opening, Diagnostic
0BBJ7ZX| Excision of Left Lower Lung Lobe, Via Natural or Artificial Opening, Diagnostic
0BBM4ZX| Excision of Bilateral Lungs, Percutaneous Endoscopic Approach, Diagnostic
0BH073Z| Insertion of Infusion Device into Tracheobronchial Tree, Via Natural or Artificial Opening
0BH07DZ| Insertion of Intraluminal Device into Tracheobronchial Tree, Via Natural or Artificial Opening
0BBM7ZX| Excision of Bilateral Lungs, Via Natural or Artificial Opening, Diagnostic
0BBL7ZX| Excision of Left Lung, Via Natural or Artificial Opening, Diagnostic
0BBK7ZX| Excision of Right Lung, Via Natural or Artificial Opening, Diagnostic
0BBD7ZX| Excision of Right Middle Lung Lobe, Via Natural or Artificial Opening, Diagnostic

2024 Physician Relative Value Units (RVUs) 4

CPT

Code

| ****

CPT Long Descriptor

| Non- Facility RVUs| Facility RVUs
---|---|---|---
31615| Tracheobronchoscopy through established tracheostomy incision| 5.18| 3.46
31622| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with cell washing| 7.48| 3.9
31623| Bronchoscopy, rigid or flexible, including fluoroscopic guidance ,when performed; diagnostic, with brushing or protected brushings| 8.21| 3.87
31624| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with broncheal alveolar lavage| 7.64| 3.92
31625| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with bronchial or endobronchial biopsy(s), single or multiple sites| 10.43| 4.58
31626| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with placement of fiducial markers, single or multiple| 23.44| 5.78
31627| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with computer-assisted, image-guided navigation| 31.81| 2.82
31628| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with transbronchial lung biopsy(s), single lobe| 11.11| 5.15
31629| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with transbronchial needle aspiration biopsy(s). Trachea, main stem and/or lobar bronchus(i)| 13.52| 5.47
31630| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with tracheal/bronchial dilation or closed reduction of fracture| NA| 5.82
31631| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with placement of tracheal stent(s)(includes tracheal/bronchial dilation as required| NA| 6.63
31632| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with transbronchial lung biopsy(s), each additional lobe (list separately in addition to code for primary procedure)| 1.93| 1.43
31633| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with transbronchial needle aspiration biopsy(s), each additional lobe (list separately in addition to code for primary procedure)| 2.4| 1.84
31634| Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, with assessment of air leak, with administration of occlusive substance (eg, fibrin glue), if performed| 43.82| 5.51
31635| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with removal of foreign body| 8.77| 5.15
31636| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with placement of bronchial stent(s)(includes tracheal/bronchial dilation as required), initial bronchus| NA| 6.34
31637| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, each additional major bronchus stented (list separately in addition to code for primary procedure)| NA| 2.22
31638| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with revision of tracheal or bronchial stent insreted at previous session (includes tracheal/bronchial dilation as required)| NA| 7.2
31640| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with excision of tumor| NA| 7.24
31641| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with destruction of tumor or relief of stenosis by any method other than excision (eg laser therapy, cryotherapy)| NA| 7.44

CPT

Code

| ****

CPT Long Descriptor

| Non- Facility RVUs| Facility RVUs
---|---|---|---
31643| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with placement of catheter(s) for intracavitary radioelement application| NA| 4.96
31645| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with therapeutic aspiration of tracheobronchial tree, initial| 8.21| 4.32
31646| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with therapeutic aspiration of tracheobronchial tree, subsequent, sams hospital stay| NA| 4.17
31647| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), initial lobe| NA| 6.01
31648| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with removal of bronchial valve(s), initial lobe| NA| 5.8
31649| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with removal of bronchial valve(s), each additional lobe (list separately in addition to code for primary procedure)| 1.95| 1.95
31652| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration(s)/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures| 37.1| 6.45
31653| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration(s)/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures| 38.51| 7.15
31654| Bronchoscopy, rigid or flexible, including fluroscopic guidance ,when performed; diagnostic, with endobronchial ultrasound (EBUS) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion(s)| 3.6| 1.96
31660| Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 1 lobe| NA| 5.55
31661| Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 2 or more lobes| NA| 5.86
31780| Excision tracheal stenosis and anastomosis; cervical| NA| 35.98
31781| Excision tracheal stenosis and anastomosis; cervicothoracic| NA| 43.08
31785| Excision of tracheal tumor or carcinoma; cervical| NA| 32.22
31786| Excision of tracheal tumor or carcinoma; thoracic| NA| 42.61
32200| Pneumonostomy, with open drainage of abscess or cyst| NA| 33.89
32400| Biopsy, pleura, percutaneous needle| 5.04| 2.46
32550| Insertion of indwelling tunneled pleural catheter with cuff| 23.04| 6
32551| Tube thoracostomy, includes connection to drainage system (eg, water seal), when performed, open (separate procedure)| NA| 4.59
32552| Removal of indwelling tunneled pleural catheter with cuff| 5.46| 4.66
32554| Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance| 7.01| 2.61
32674| Thoracoscopy, surgical; with mediastinal and regional lymphadenectomy (List separately in addition to code for primary procedure)| NA| 6.31
32815| Open closure of major bronchial fistula| NA| 82.63

aScope 5 Broncho Device Offset Amounts

A device offset is the part of the APC amount that is associated with the cost of the pass-through device. Each CPT code will have a specific device offset amount which will be used to calculate the TPT payment.

CPT

Code

| Description| Device Offset Amount7
---|---|---
31615| Tracheobronchoscopy through established tracheostomy incision| $0.16
31622| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with cell washing| $8.57
31623| Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with brushing or protected brushings| $6.47
31624| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with broncheal alveolar lavage| $2.91
31625| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with bronchial or endobronchial biopsy(s), single or multiple sites| $14.88
31626| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with placement of fiducial markers, single or multiple| $652.77
31628| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with transbronchial lung biopsy(s), single lobe| $36.04
31629| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with transbronchial needle aspiration biopsy(s). Trachea, main stem and/or lobar bronchus(i)| $44.96
31630| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with tracheal/ bronchial dilation or closed reduction of fracture| $421.03
31631| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with placement of tracheal stent(s) (includes tracheal/bronchial dilation as required| $1,688.99
31634| Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, with assessment of air leak, with administration of occlusive substance (eg, fibrin glue), if performed| $1,161.42
31635| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with removal of foreign body| $14.39
31636| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with placement of bronchial stent(s)(includes tracheal/bronchial dilation as required), initial bronchus| $2,808.68
31638| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with revision of tracheal or bronchial stent insreted at previous session (includes tracheal/ bronchial dilation as required)| $907.75
31640| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with excision of tumor| $132.02
31641| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with destruction of tumor or relief of stenosis by any method other than excision (eg laser therapy, cryotherapy)| $251.90
31643| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with placement of catheter(s) for intracavitary radioelement application| $10.51
31645| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with therapeutic aspiration of tracheobronchial tree, initial| $12.61
31646| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with therapeutic aspiration of tracheobronchial tree, subsequent, sams hospital stay| $0.00
31647| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), initial lobe| $3,704.69
31648| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with removal of bronchial valve(s), initial lobe| $87.77

CPT

Code

| Description| Device Offset Amount7
---|---|---
31652| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration(s)/ biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures| $27.12
31653| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration(s)/ biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures| $27.83
31660| Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 1 lobe| $3,220.16
31661| Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 2 or more lobes| $3,055.83
31785| Excision of tracheal tumor or carcinoma; cervical| $83.14
31627| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with computer- assisted, image-guided navigation| NA
31632| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with transbronchial lung biopsy(s), each additional lobe (list separately in addition to code for primary procedure)| NA
31633| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with transbronchial needle aspiration biopsy(s), each additional lobe (list separately in addition to code for primary procedure)| NA
31637| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, each additional major bronchus stented (list separately in addition to code for primary procedure)| NA
31649| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with removal of bronchial valve(s), each additional lobe (list separately in addition to code for primary procedure)| NA
31651| #N/A| NA
31654| Bronchoscopy, rigid or flexible, including fluroscopic guidance, when performed; diagnostic, with endobronchial ultrasound (EBUS) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion(s)| NA
31780| Excision tracheal stenosis and anastomosis; cervical| NA
31781| Excision tracheal stenosis and anastomosis; cervicothoracic| NA
31786| Excision of tracheal tumor or carcinoma; thoracic| NA
31800| Suture of tracheal wound or injury; cervical| NA
31805| Suture of tracheal wound or injury; intrathoracic| NA
32815| Open closure of major bronchial fistula| NA

PLACE OF SERVICE

The place of service, as defined by the Centers for Medicare & Medicaid Services (CMS), where a procedure is completed determines which physician service payment is applicable (i.e., non-facility (clinic) or facility), as well as whether a facility payment is applicable and if so which type of facility payment. The CMS-defined places of service are listed in the table below.6 The table also indicates which type of physician payment is applicable to each place of service (see table on pages 2-4 for physician payment rates).

Code

|

Name

| Applicable Physician Payment| Applicable Facility Payment|

Description (defined by CMS)

---|---|---|---|---
11| Office| Non-Facility| None| Location, other than a hospital, skilled nursing facility (SNF), military treatment facility, community health center, State or local public health clinic, or intermediate care facility (ICF), where the health professional routinely provides health examinations, diagnosis, and treatment of illness or injury on an ambulatory basis.
19| Off Campus Outpatient Hospital| Facility| HOPD| A portion of an off-campus hospital provider based department which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization.
21| Inpatient Hospital| Facility| Inpatient| A facility, other than psychiatric, which primarily provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services by, or under, the supervision of physicians to patients admitted for a variety of medical conditions.
22| On Campus Outpatient Hospital| Facility| HOPD| A portion of a hospital’s main campus which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization. (Description change effective January 1, 2016).
23| Emergency Room – Hospital| Facility| HOPD| A portion of a hospital where emergency diagnosis and treatment of illness or injury is provided.
24| Ambulatory Surgical Center (ASC)| Facility| ASC| A freestanding facility, other than a physician’s office, where surgical and diagnostic services are provided on an ambulatory basis.

REFERENCES

1. Current Procedural Terminology (CPT®) is a registered trademark of the American Medical Association (AMA). Copyright 2021 All rights reserved. No fee schedules, basic units, relative value units, or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use.
2. 2024 CMS PFS Final Rule, Addendum B (available on CMS website), (January 2024).
3. 2024 CMS OPPS/ASC Final Rule, Addendum AA and B (available on CMS website), (January 2024).
4. CMS PFS Relative Value Available at:

https://www.cms.gov/medicare/payment/fee-schedules/physician/pfs-relative- value-files.

5. Items that are insertable may be billed with revenue code 0278 per the National Uniform Billing Committee (NUBC)’s Updated Guidance on Other Implant Revenue Code (0278) effective July 1, 2020 available at https://www.nubc.org/system/files/media/file/2020/04/Guidance%20on%20 Other%20Implant%20RC0278.pdf
6. CMS Place of Service Code Available at https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set.
7. Offset data published in CMS Transmittal MM13488 with additional values accessed via pdf (cms.gov)

INDICATIONS FOR USE

The endoscope is a sterile, single-use, flexible endoscope intended for endoscopic procedures and examination within the nasal lumens and upper airway anatomy. The endoscope is intended to provide visualization via a monitor.
The endoscope is intended for use in a hospital environment. It is designed for use in adults.

DISCLAIMER

The reimbursement information provided in this guide was obtained from third- party sources and information that is publicly available on the internet. The reported Medicare national average payments are subject to change and may vary based on geographic location and other individual factors.
Information in this Guide is not legal advice, nor is it advice about how to code or complete claims for payment. It is the provider’s responsibility to report the appropriate codes based on the procedures furnished to a specific patient and the patient’s documented medical condition.Providers are also responsible for submitting claims for these services consistent with the specific payer billing requirements.

Payer billing, coding, and coverage requirements vary from payer to payer and are updated and change over time. Ambu encourages providers to verify current billing, coding and coverage policies and requirements with the specific payer if the provider has questions. Providers may also contact the American Academy of Otolaryngology-Head and Neck Surgery and/or the American Medical Association (AMA).
Ambu does not promote the use of its products outside of the FDA cleared indications for use and labeling.

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References

• Ambu USA - The Single-Use Endoscopy Leader
• calculator - Single-Use-Endoscopy

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