How To Use CPT Code 32097

CPT 32097 describes the procedure of thoracotomy with diagnostic biopsy(ies) of lung nodule(s) or mass(es) on one side of the chest. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 32097?

CPT 32097 is used to describe a surgical procedure called thoracotomy with diagnostic biopsy(ies) of lung nodule(s) or mass(es) on one side of the chest. This code is specifically used when the provider creates an open surgical incision into the pleural space/cavity of the chest and takes one or more abnormal lung mass biopsies.

2. Official Description

The official description of CPT code 32097 is: ‘Thoracotomy, with diagnostic biopsy(ies) of lung nodule(s) or mass(es) (eg, wedge, incisional), unilateral.’

3. Procedure

1. When performing CPT 32097, the provider begins by appropriately prepping and anesthetizing the patient.
2. An open surgical incision is made into the patient’s chest, from the front to the back, allowing access to the pleural space of the chest.
3. The provider may drain any excess fluid that has accumulated due to pleural effusion.
4. One or more abnormal lung masses or nodules are biopsied or removed by the provider.
5. The biopsied tissue samples are sent to the laboratory for further investigation.
6. If necessary, the provider may take samples from additional nodules or masses.
7. Finally, the provider closes the surgical incision, and flexible tubes may be left in the chest to drain fluid, air, and blood.

4. Qualifying circumstances

CPT 32097 is performed on patients who require diagnostic biopsy(ies) of lung nodule(s) or mass(es). The procedure is typically done when there is suspicion of abnormal growth in the lung, such as a lung nodule or mass. The provider must create an open surgical incision into the pleural space/cavity of the chest and perform the biopsy(ies) on one side of the chest. It is important to note that CPT 32097 should not be reported more than once per lung and should not be reported in conjunction with codes 32440, 32442, 32445, or 32488.

5. When to use CPT code 32097

CPT code 32097 should be used when the provider performs a thoracotomy with diagnostic biopsy(ies) of lung nodule(s) or mass(es) on one side of the chest. It is important to ensure that the procedure is performed only once for single or multiple biopsies on a single lung. If biopsies are performed on both lungs, follow the payer’s instructions for reporting a bilateral service, such as appending modifier 50.

6. Documentation requirements

To support a claim for CPT 32097, the provider must document the following information:

• Patient’s diagnosis and the need for diagnostic biopsy(ies) of lung nodule(s) or mass(es)
• Details of the procedure, including the specific incision technique used
• Number of biopsies performed and the location of each biopsy
• Any additional procedures performed during the thoracotomy
• Any complications or unexpected findings
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 32097, ensure that the procedure is performed as described in the official description. It is important to note that CPT 32097 should not be reported more than once per lung and should not be reported in conjunction with codes 32440, 32442, 32445, or 32488. If biopsies are performed on both lungs, follow the payer’s instructions for reporting a bilateral service, such as appending modifier 50.

8. Historical information

CPT 32097 was added to the Current Procedural Terminology system on January 1, 2012. It was later added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A patient undergoes a thoracotomy with diagnostic biopsy of a lung nodule on the right side of the chest.
2. A provider performs a thoracotomy with diagnostic biopsies of multiple lung nodules on the left side of the chest.
3. During a thoracotomy, a surgeon removes a mass from the right lung for further investigation.
4. A patient undergoes a thoracotomy with diagnostic biopsy of a lung nodule on the left side of the chest, along with a mediastinal lymphadenectomy.
5. A provider performs a thoracotomy with diagnostic biopsies of lung nodules on both sides of the chest, followed by a radical resection of tumors.
6. During a thoracotomy, a surgeon removes multiple lung masses on the right side of the chest and sends them to the laboratory for investigation.
7. A patient undergoes a thoracotomy with diagnostic biopsy of a lung mass on the left side of the chest, along with a mediastinal lymphadenectomy and radical resection of the tumor.
8. A provider performs a thoracotomy with diagnostic biopsies of lung nodules on both sides of the chest, followed by a mediastinal lymphadenectomy.