How To Use CPT Code 32604

CPT 32604 describes the use of thoracoscopy, a diagnostic procedure that involves visualizing the thorax and taking a sample of the pericardial sac for pathological evaluation. This article will cover the description, official definition, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 32604?

CPT 32604 is a code used to describe a diagnostic procedure called thoracoscopy. This procedure involves the use of an endoscope to visualize the thorax and take a sample of the pericardial sac for pathological evaluation. It is important to note that this code should only be reported if it is not integral to another procedure.

2. Official Description

The official description of CPT code 32604 is: ‘Thoracoscopy, diagnostic (separate procedure); pericardial sac, with biopsy.’ It is important to use code 32601 for diagnostic thoracoscopy without biopsy and code 32606 for diagnostic thoracoscopy with mediastinal space biopsy.

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. An incision is made between two ribs to enter the thoracic cavity.
3. An endoscope is inserted through the incision and between the ribs.
4. The provider uses the camera on the endoscope to examine the thorax.
5. Surgical instruments are inserted through other incisions to take one or more pericardial sac samples for biopsy.
6. Chest drains may be placed to re-expand the lungs and allow for drainage of air, blood, or fluid.
7. The incisions are closed with stitches.

4. Qualifying circumstances

CPT 32604 is used when a provider performs a thoracoscopy to visualize the thorax and take a sample of the pericardial sac for pathological evaluation. This procedure is typically performed on patients who require further evaluation of their pericardial sac due to suspected disease or other conditions. It is important to note that this code should only be reported if it is not integral to another procedure.

5. When to use CPT code 32604

CPT code 32604 should be used when a provider performs a separate diagnostic thoracoscopy specifically to obtain a biopsy sample from the pericardial sac. It is important to note that this code should only be reported if it is not integral to another procedure.

6. Documentation requirements

To support a claim for CPT code 32604, the provider must document the following information:

• Patient’s diagnosis or reason for the procedure
• Details of the thoracoscopy procedure, including the use of an endoscope and the number of incisions made
• Specific location of the pericardial sac biopsy
• Pathological evaluation of the biopsy sample
• Any additional procedures performed during the same session
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 32604, ensure that the procedure is a separate diagnostic thoracoscopy specifically for pericardial sac biopsy. It is important to note that this code should only be reported if it is not integral to another procedure. Additionally, it is important to use the appropriate codes (32601 or 32606) if the procedure involves diagnostic thoracoscopy without biopsy or with mediastinal space biopsy, respectively.

8. Historical information

CPT code 32604 was added to the Current Procedural Terminology system on January 1, 1994. There have been no updates to the code since its addition.

9. Examples

1. A provider performs a thoracoscopy to visualize the thorax and takes a pericardial sac sample for pathological evaluation in a patient with suspected pericardial disease.
2. A patient presents with symptoms of pericardial effusion, and a provider performs a thoracoscopy to obtain a biopsy sample from the pericardial sac for further evaluation.
3. A provider performs a thoracoscopy to investigate the cause of recurrent pericarditis and takes a pericardial sac sample for pathological examination.
4. A patient with a history of pericardial disease undergoes a thoracoscopy to monitor the progression of the condition and obtain a pericardial sac sample for biopsy.
5. A provider performs a thoracoscopy to evaluate a patient with suspected pericardial tumor and takes a pericardial sac sample for pathological analysis.
6. A patient with a known pericardial disease undergoes a thoracoscopy to assess the effectiveness of previous treatments and obtain a pericardial sac sample for further evaluation.
7. A provider performs a thoracoscopy to investigate the cause of unexplained chest pain and takes a pericardial sac sample for pathological examination.
8. A patient with a history of pericardial effusion undergoes a thoracoscopy to assess the recurrence of the condition and obtain a pericardial sac sample for biopsy.
9. A provider performs a thoracoscopy to evaluate a patient with suspected pericardial infection and takes a pericardial sac sample for pathological analysis.
10. A patient with a known pericardial tumor undergoes a thoracoscopy to monitor the progression of the disease and obtain a pericardial sac sample for further evaluation.