The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Endobronchial ultrasound-guided transbronchial biopsy for peripheral lung lesions.


Lung lumps are commonly investigated using a thin flexible telescope (bronchoscope) inserted into the airways of the lung via the patient’s mouth or nose. Ultrasound-guided transbronchial biopsy is intended for diagnosing patients with a lung lump that cannot be reached by conventional bronchoscopy because the lump does not protrude into the airways. With the patient under local or general anaesthetic, a bronchoscope including an ultrasound probe is used instead of a conventional bronchoscope. Ultrasound images of the lung are obtained through the bronchoscope and these help to guide the doctor to the location of the lump, to obtain samples for further tests.

Coding recommendations

E49.1 Diagnostic fibreoptic endoscopic examination of lower respiratory tract and biopsy of lesion of lower respiratory tract


Y53.2 Approach to organ under ultrasonic control 


Y76.4 Endoscopic ultrasonic approach to other body cavity

Note: The OPCS-4 code Y53.4 Approach to organ under fluoroscopic control can be assigned in addition if fluoroscopic guidance is utilised.

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