How To Use CPT Code 32140

CPT 32140 describes a surgical procedure involving the removal of one or more cysts from the lungs, along with any necessary procedures on the pleura. 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 32140?

CPT 32140 is used to describe a surgical procedure in which a qualified healthcare provider removes one or more cysts from the patient’s lungs. This code may also include any necessary procedures performed on the pleura, which is the membrane surrounding the lungs. It is important to note that CPT 32140 should only be reported once, even if multiple cysts are removed during the same operative session.

2. Official Description

The official description of CPT code 32140 is: ‘Thoracotomy; with cyst(s) removal, includes pleural procedure when performed.’

3. Procedure

1. The healthcare provider begins by making an incision in the thoracic cavity of the patient, gaining access to the organs within, such as the heart, lungs, esophagus, thoracic aorta, and anterior spine.
2. The provider may perform a major thoracotomy to conduct exploratory surgery, determine a diagnosis, or assess the extent of injury or damage.
3. The most common approaches for lung procedures are the posterolateral thoracotomy and anterolateral thoracotomy.
4. If a posterolateral incision is used, it starts at the sternum and extends across to the side, reaching the back. An anterolateral incision starts at the sternum and goes across to the side just below the armpit.
5. The provider may use rib spreaders to widen the opening and gain better access to the internal chest tissues.
6. Once access is achieved, the provider removes one or more cysts from the lungs.
7. Additional procedures may be performed on the pleura, such as clearing adhesions, if necessary.
8. After completing the surgical procedure, the provider may place one or more chest drains to aid in lung re-expansion and drainage of air, blood, or fluid.
9. The incision is closed in layers, typically using stitches.

4. Qualifying circumstances

CPT 32140 is performed on patients who require the removal of one or more cysts from their lungs. The procedure may also involve additional interventions on the pleura. It is important to note that this code is specific to the removal of cysts and should not be used for other lung or pleural procedures.

5. When to use CPT code 32140

CPT code 32140 should be used when a healthcare provider performs a thoracotomy to remove one or more cysts from the patient’s lungs. This code may also be used if additional procedures are performed on the pleura during the same operative session. It is important to report CPT 32140 only once, even if multiple cysts are removed.

6. Documentation requirements

To support a claim for CPT 32140, the healthcare provider must document the following information:

• Patient’s diagnosis necessitating the removal of cysts
• Details of the surgical procedure performed, including any additional interventions on the pleura
• Date of the procedure
• Start and end time of the procedure
• Any complications or unexpected findings
• Use of chest drains, if applicable
• Incision closure method
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 32140, ensure that the procedure involves the removal of one or more cysts from the lungs and may include additional procedures on the pleura. It is important to report this code only once, even if multiple cysts are removed during the same operative session. Take note of any specific guidelines provided by payers regarding the use of CPT 32140 and its appropriate reporting with other codes.

8. Historical information

CPT 32140 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2012, with the updated description including the option for a pleural procedure. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A qualified healthcare provider performs a thoracotomy to remove a cyst from a patient’s lung.
2. During a surgical procedure, a provider removes multiple cysts from a patient’s lungs and performs additional interventions on the pleura.
3. A patient undergoes a thoracotomy for the removal of a large cyst from their lung, which requires additional procedures on the pleura.
4. A healthcare provider performs a thoracotomy to remove a cyst from a patient’s lung and discovers unexpected adhesions on the pleura, which are also addressed during the procedure.
5. During a surgical intervention, a provider removes a cyst from a patient’s lung and places a chest drain to aid in lung re-expansion.
6. A patient undergoes a thoracotomy for the removal of multiple cysts from their lungs, with no additional procedures performed on the pleura.
7. A healthcare provider performs a thoracotomy to remove a cyst from a patient’s lung and closes the incision using stitches.
8. During a surgical procedure, a provider removes a cyst from a patient’s lung and performs additional interventions on the pleura, including the clearance of adhesions.
9. A patient undergoes a thoracotomy for the removal of a cyst from their lung, with no additional procedures performed on the pleura.