How To Use CPT Code 32550

CPT 32550 describes the insertion of an indwelling tunneled pleural catheter with a cuff. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 32550?

CPT 32550 involves the placement of a chest tube with a cuff via thoracostomy using a tunneled procedure. This code is used when a healthcare provider inserts a hollow needle into the pleural space, passes a tunneling device with the catheter subcutaneously, and advances the catheter until the cuff is buried just under the second incision. The provider then inserts the catheter into the pleural space and secures it.

2. Official Description

The official description of CPT code 32550 is the insertion of an indwelling tunneled pleural catheter with a cuff via thoracostomy using a tunneled procedure. It is important to note that this code should not be reported in conjunction with codes 32554, 32555, or 32556 when performed on the same side of the chest. If imaging guidance is performed during the procedure, code 75989 should be used.

3. Procedure

1. The healthcare provider makes an incision in the chest and inserts a hollow needle into the pleural space.
2. A guide wire is inserted through the needle and left in place.
3. A second incision is made, and a tunneling device with the catheter is passed subcutaneously until it exits through the original incision site.
4. The catheter is advanced using the tunneling device until the cuff is buried just under the second incision.
5. A dilator is fed over the guide wire into the pleural space, and the catheter is inserted and secured.
6. The chest tube is left in place with one end exiting the body for connection to a collection container.
7. The original upper incision is closed with staples or stitches.

4. Qualifying circumstances

CPT 32550 is performed when a patient requires the insertion of an indwelling tunneled pleural catheter with a cuff. This procedure is typically performed on patients with fluid in the pleural cavity that needs to be drained into a vacuum container. The catheter is flexible and allows for continuous drainage. The provider must ensure that the procedure is not performed on the same side of the chest as codes 32554, 32555, or 32556. If imaging guidance is used during the procedure, code 75989 should be reported separately.

5. When to use CPT code 32550

CPT code 32550 should be used when a healthcare provider performs the insertion of an indwelling tunneled pleural catheter with a cuff via thoracostomy using a tunneled procedure. It is important to note that this code should not be reported in conjunction with codes 32554, 32555, or 32556 when performed on the same side of the chest. If imaging guidance is performed during the procedure, code 75989 should be used.

6. Documentation requirements

To support a claim for CPT code 32550, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for the indwelling tunneled pleural catheter
• Details of the procedure, including the use of a tunneling device and the placement of the catheter with a cuff
• Date of the procedure
• Any additional procedures performed during the same session
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 32550, ensure that the procedure is performed by a qualified healthcare provider and that it meets the criteria for the insertion of an indwelling tunneled pleural catheter with a cuff. It is important to note that this code should not be reported in conjunction with codes 32554, 32555, or 32556 when performed on the same side of the chest. If imaging guidance is used during the procedure, code 75989 should be reported separately. Additionally, it is important to follow any specific guidelines provided by the payer regarding the use of this code.

8. Historical information

CPT code 32550 was added to the Current Procedural Terminology system on January 1, 2008. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider inserts an indwelling tunneled pleural catheter with a cuff via thoracostomy using a tunneled procedure to drain fluid from the pleural cavity into a vacuum container.
2. A patient with recurrent pleural effusion undergoes the insertion of an indwelling tunneled pleural catheter with a cuff to facilitate continuous drainage.
3. A healthcare provider performs the insertion of an indwelling tunneled pleural catheter with a cuff to manage a patient with malignant pleural effusion.
4. An individual with a history of recurrent pneumothorax undergoes the placement of an indwelling tunneled pleural catheter with a cuff to allow for continuous drainage of air.
5. A patient with a large pleural effusion undergoes the insertion of an indwelling tunneled pleural catheter with a cuff to relieve symptoms and improve lung function.