How To Use CPT Code 32505

CPT 32505 describes the procedure of thoracotomy with therapeutic wedge resection. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 32505?

CPT 32505 is used to describe a specific surgical procedure called thoracotomy with therapeutic wedge resection. This procedure involves creating an open surgical incision into the pleural space or cavity of the chest and removing a triangular-shaped portion of the lung affected by a mass, nodule, or other condition. It is important to note that CPT 32505 represents the initial resection during the procedure.

2. Official Description

The official description of CPT code 32505 is: ‘Thoracotomy; with therapeutic wedge resection (eg, mass, nodule), initial.’

3. Procedure

1. The patient is brought into the operating room and administered adequate anesthesia.
2. The healthcare provider makes an incision between two ribs using a scalpel and blunt forceps to access the chest cavity.
3. Two fingers are inserted through the incisions to hold the lung out of the way.
4. The provider uses heavy scissors to cut through all layers of the intercostal muscles and pleura in the direction of the sternum.
5. The sternum is cut using scissors, and a retractor is used to expose all areas of the chest.
6. A small wedge-shaped portion of the abnormal lung affected by a mass, nodule, or other condition is removed.
7. The remaining area of lung tissue is repaired.
8. The wound is closed using sutures and wiring of the two ends of the sternum.
9. Flexible tubes may be left in the chest to drain out fluid, air, and blood.

4. Qualifying circumstances

CPT 32505 is performed when a therapeutic wedge resection is necessary to remove a mass, nodule, or other abnormality from the lung. It is important to note that CPT 32505 should not be reported in conjunction with codes 32440, 32442, 32445, or 32488.

5. When to use CPT code 32505

CPT code 32505 should be used when a healthcare provider performs the initial therapeutic wedge resection procedure. If subsequent resections are performed on the same lung during the same session, CPT code 32506 should be used.

6. Documentation requirements

To support a claim for CPT 32505, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for therapeutic wedge resection
• Details of the procedure, including the specific area of the lung affected and the reason for the resection
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures performed during the same session
• Any complications or unexpected findings
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 32505, ensure that the procedure meets the criteria for this specific code. It is important to note that CPT 32505 should not be reported in conjunction with codes 32440, 32442, 32445, or 32488. If a therapeutic wedge resection is performed in a different lobe than a more extensive lung resection procedure like lobectomy, CPT 32505 should be reported with modifier 59 in addition to the lobectomy code for the opposite lung.

8. Historical information

CPT 32505 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 thoracotomy with therapeutic wedge resection to remove a mass from their lung.
2. A healthcare provider performs thoracotomy with therapeutic wedge resection to excise a nodule from a patient’s lung.
3. During a surgical procedure, a therapeutic wedge resection is performed to remove an abnormal portion of the lung affected by a mass.
4. A patient with a lung condition undergoes thoracotomy with therapeutic wedge resection to remove a tumor.
5. A healthcare provider performs thoracotomy with therapeutic wedge resection to excise a mass from a patient’s lung.
6. During a surgical procedure, a therapeutic wedge resection is performed to remove a nodule from the lung.
7. A patient undergoes thoracotomy with therapeutic wedge resection to remove a mass from their lung.
8. A healthcare provider performs thoracotomy with therapeutic wedge resection to excise a nodule from a patient’s lung.
9. During a surgical procedure, a therapeutic wedge resection is performed to remove an abnormal portion of the lung affected by a mass.
10. A patient with a lung condition undergoes thoracotomy with therapeutic wedge resection to remove a tumor.