CPT 31622 Billing Guide: Bronchoscopy Coding, Documentation, and Denial Prevention
CPT 31622 is the base diagnostic bronchoscopy code — and the code most often billed when it shouldn't be. It's officially designated a “separate procedure,” which means it's bundled into nearly every more extensive bronchoscopy service performed in the same session. Billing 31622 alongside a biopsy, lavage, or brushing code from the same encounter is one of the most common, most avoidable denial triggers in pulmonary billing.
This guide covers what 31622 actually represents, when it's billed on its own versus bundled into something else, documentation that supports the claim, and where denials typically start.
CPT 31622 Quick Facts
Field | Detail |
CPT Code | 31622 |
Procedure Category | Diagnostic bronchoscopy (rigid or flexible), with fluoroscopic guidance when performed |
Includes | Visualization of the airways, with or without simple cell washing |
Code Type | “Separate procedure” — bundled into more extensive bronchoscopy codes performed the same session |
Primary Specialty | Pulmonology and related specialties performing bronchoscopy |
Key Billing Risk | Billed alongside 31623–31654 from the same session when it should be bundled |
Documentation Focus | Indication, findings, and whether a more extensive service was actually performed |
What CPT 31622 Covers
31622 reports a bronchoscope passed through the upper airway to visualize the trachea and bronchial tree down to the segmental level, with or without a simple cell washing sent for cytology. Fluoroscopic guidance, when used, is included in the code rather than billed separately. It does not include brushing, lavage, biopsy, or any of the more extensive bronchoscopy services — each of those has its own code.
THE RULE THAT MATTERS MOST 31622 is designated a “separate procedure” in CPT. That means when a more extensive bronchoscopy service — brushing (31623), lavage (31624), biopsy (31625), and the rest of the bronchoscopy family — is performed in the same session, the diagnostic bronchoscopy is bundled into it and isn't billed separately, even though the physician technically performed the diagnostic inspection first. 31622 is only billed on its own when the bronchoscopy was purely diagnostic — nothing more extensive was done. |
CPT 31622 vs. the Rest of the Bronchoscopy Family
Choosing the right code comes down to what was actually done beyond the diagnostic inspection itself:
Code | What's Added Beyond 31622 |
31622 | Diagnostic inspection only, with or without simple cell washing |
31623 | Brushing or protected brushings |
31624 | Bronchoalveolar lavage (larger-volume saline instillation than a simple washing) |
31625 | Bronchial or endobronchial biopsy, single or multiple sites |
31628 / +31632 | Transbronchial lung biopsy — single lobe / each additional lobe |
31629 / +31633 | Transbronchial needle aspiration — initial site / each additional lobe |
31652 / 31653 | EBUS with transbronchial needle aspiration — 1–2 / 3+ mediastinal or hilar nodal stations |
Only one base or add-on bronchoscopy code combination applies per session based on what was actually performed — 31622 doesn't stack alongside these; it's replaced by whichever more extensive code describes the service.
Documentation That Supports a 31622 Claim
Documentation Check ☐ Indication for the bronchoscopy ☐ Relevant clinical history ☐ Approach (rigid or flexible) and whether fluoroscopic guidance was used ☐ Airways visualized, down to the segmental level ☐ Findings, including absence of abnormal findings if applicable ☐ Whether cell washing was performed ☐ Explicit statement that no biopsy, brushing, lavage, or other more extensive service was performed, if that's the case ☐ Medical necessity for the procedure ☐ Complications, or their absence ☐ Provider's final note, signed and dated |
That second-to-last item matters more than it looks: if the note is ambiguous about whether anything beyond inspection happened, a coder can't confirm 31622 is the correct — and only — code for that session.
Modifier Considerations
Before You Add a Modifier, Ask 1. Was a genuinely distinct procedure performed, not just the diagnostic portion of a more extensive bronchoscopy? 2. Does the documentation clearly support that distinct circumstance? 3. Does this payer recognize the modifier in this specific situation? 4. Do NCCI edits or payer-specific bundling rules apply here? 5. Does the medical record, read on its own, support what the modifier is claiming? |
Modifier 59 (or a more specific X-modifier) only applies to 31622 when it represents a genuinely separate procedure — for example, a distinct bronchoscopy for an unrelated indication in the same session — not as a routine override to bill it alongside a more extensive bronchoscopy code. Bronchoscopy codes also aren't billed with modifier 50 for bilateral procedures; the single code already covers inspection of both lungs' airways within that session.
Common CPT 31622 Billing Mistakes
Mistake | Better Approach |
31622 billed alongside a more extensive bronchoscopy code from the same session | Confirm whether a more extensive service was performed; if so, bill only that code |
Incomplete documentation of findings or approach | Review documentation against the checklist above before coding |
Modifier 59 applied routinely to bypass the bundling edit | Reserve it for genuinely distinct, documented circumstances |
Fluoroscopic guidance billed as a separate line | Confirm it's included in 31622, not reported separately |
Diagnosis doesn't support medical necessity | Confirm the ICD-10 code matches the documented indication |
Claim not checked against current payer and NCCI edits | Run a pre-submission claim scrub specific to bronchoscopy bundling rules |
Could Your Bronchoscopy Claim Be at Risk?
Denial Risk Check ☐ Does the documentation clearly support that only a diagnostic bronchoscopy was performed? ☐ Does the selected code match the full scope of what was actually done? ☐ Were current payer requirements checked before submission? ☐ Were applicable NCCI bundling edits reviewed? ☐ Was the claim reviewed before submission, not just after a denial? |
If the answer to any of these is no, the claim — or the broader bronchoscopy billing workflow — may be worth a closer look before more claims go out the same way.
Is your documentation supporting your bronchoscopy claims? Small gaps in documentation create avoidable billing problems. MedCloudMD's billing specialists can review your pulmonary coding and claims workflow. |
Step-by-Step CPT 31622 Billing Workflow
Step | What Happens |
1. Review the clinical record | Confirm indication and what was actually documented |
2. Confirm the procedure performed | Diagnostic only, or something more extensive? |
3. Verify code selection | 31622 alone, or the correct code for a more extensive service |
4. Review documentation | Check against the documentation checklist above |
5. Check payer requirements and coding edits | NCCI bundling, payer-specific policy, modifier support |
6. Validate claim information | Diagnosis, code, and modifiers match the note exactly |
7. Submit the claim | Clean claim, first pass |
8. Monitor payment and A/R | Confirm payment matches the expected rate |
9. Address denials or underpayments | Trace the root cause, not just the individual claim |
How Much Does CPT 31622 Reimburse?
There's no single figure that applies to every claim — reimbursement depends on the payer, site of service (facility vs. non-facility), geographic locality, contracted rate, and whether 31622 is billed on its own or bundled into a more extensive bronchoscopy code. For Medicare claims, the CMS Physician Fee Schedule Look-Up Tool reflects the current, locality-adjusted rate — a more reliable source than any fixed number, since rates update annually.
How MedCloudMD Helps
MedCloudMD is an AI-powered medical billing company supported by human billing expertise. For pulmonary and bronchoscopy billing specifically, that means coding support that catches bundling conflicts before submission, denial management that traces problems to their root cause, accounts receivable follow-up, eligibility verification, and reporting that shows where claims are actually getting stuck — not guesses, not guarantees, just a closer look at the workflow.
Finding too many billing problems? Our revenue cycle experts can help identify coding, claims, denial, A/R, and workflow issues affecting your practice. |
CPT 31622 FAQ
What is CPT 31622?
The base diagnostic bronchoscopy code — visualization of the airways through the segmental bronchi, with or without simple cell washing, with fluoroscopic guidance included when used.
What does CPT 31622 cover?
Diagnostic inspection of the trachea and bronchial tree. It doesn't cover brushing, lavage, biopsy, or any more extensive bronchoscopy service — those are separate codes.
What documentation is needed for CPT 31622?
Indication, approach, airways visualized, findings, whether cell washing was performed, and confirmation that no more extensive service was performed, if that's the case.
Can CPT 31622 be billed with other bronchoscopy services?
Generally no. As a “separate procedure,” it's bundled into more extensive bronchoscopy codes (31623–31654) performed in the same session — it's billed alone only when the service was purely diagnostic.
What are common CPT 31622 billing mistakes?
Billing it alongside a more extensive bronchoscopy code from the same session, incomplete documentation, and routine use of modifier 59 to bypass the bundling edit.
Why might a CPT 31622 claim be denied?
Most often: it's billed alongside a code it should be bundled into, documentation doesn't clearly support a purely diagnostic procedure, or the diagnosis doesn't support medical necessity.
How can providers improve bronchoscopy billing accuracy?
Confirm the full scope of the procedure before coding, document clearly whether anything beyond inspection occurred, and scrub claims against current NCCI bundling edits before submission.
Does Medicare have specific requirements for CPT 31622?
Medicare follows NCCI bundling rules for this code family and doesn't recognize modifier 50 for bronchoscopy; always verify current MAC and payer-specific policy before submission.
This guide reflects AMA CPT guidance for the bronchoscopy code family, CMS's National Correct Coding Initiative bundling edits, and Medicare Administrative Contractor billing resources. Always confirm current CPT, CMS, NCCI, and payer-specific policy before submitting claims.
Medical Billing Disclaimer: This article is for general educational purposes only. CPT coding, reimbursement, coverage, authorization, and documentation requirements vary by payer, plan, jurisdiction, and individual patient circumstances, and can change without notice. Always verify current CPT guidance, NCCI edits, payer policies, and documentation standards before submitting claims. This content is not legal, coding, compliance, or medical advice.
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