How To Use CPT Code 32650

CPT 32650 describes a surgical procedure known as thoracoscopy with pleurodesis. 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 32650?

CPT 32650 is a code used to describe a surgical procedure called thoracoscopy with pleurodesis. This procedure involves the use of an endoscope to visually examine the pleura and lungs, and to assist in performing pleurodesis. Pleurodesis is a technique used to prevent pleural effusion, which is the abnormal accumulation of fluid within the chest cavity. During the procedure, the provider may mechanically or chemically irritate the pleura, causing inflammation that makes the pleural layers stick together and prevent the accumulation of fluid.

2. Official Description

The official description of CPT code 32650 is: ‘Thoracoscopy, surgical; with pleurodesis (eg, mechanical or chemical).’ This code specifically refers to the surgical procedure of thoracoscopy with pleurodesis, which can be performed using mechanical or chemical methods.

3. Procedure

1. The provider begins by creating a small incision on the side of the chest between the ribs.
2. Through one of the incisions, an endoscope is introduced to visually examine the lungs and pleura.
3. The provider may decompress the lung to ensure adequate visualization.
4. Through another incision, a rough pad on a surgical instrument is introduced to mechanically scrape the surface of the lung, inducing inflammation.
5. Alternatively, a chemical substance may be instilled into the lung space to irritate the lung coverings and induce inflammation.
6. The inflammation caused by either method makes the pleural layers stick together, preventing the reaccumulation of fluid.
7. The provider then re-expands the lungs and withdraws the endoscope and other instruments.
8. One or more tubes may be temporarily left in the chest cavity to drain fluid or air.

4. Qualifying circumstances

CPT 32650 is typically performed on patients who require pleurodesis to prevent pleural effusion. The procedure is indicated when there is an abnormal accumulation of fluid within the chest cavity. The provider must use either mechanical or chemical methods to irritate the pleura and induce inflammation. This procedure is performed by a qualified healthcare professional who has the necessary training and expertise in thoracoscopy with pleurodesis.

5. When to use CPT code 32650

CPT code 32650 should be used when a provider performs thoracoscopy with pleurodesis using either mechanical or chemical methods. This code accurately describes the specific procedure being performed and allows for proper documentation and billing. It is important to note that CPT code 32650 should not be used for other thoracoscopic procedures that do not involve pleurodesis.

6. Documentation requirements

When reporting CPT code 32650, the provider must ensure that the following documentation is included:

• Patient’s diagnosis and the need for pleurodesis
• Details of the procedure performed, including whether mechanical or chemical methods were used
• Date of the procedure
• Any additional procedures or interventions performed
• Any complications or adverse events that occurred
• Signature of the performing provider

7. Billing guidelines

When billing for CPT code 32650, it is important to follow the appropriate guidelines. Ensure that the procedure performed meets the criteria for thoracoscopy with pleurodesis and that the documentation supports the use of this code. It is also important to review any specific billing guidelines provided by insurance carriers or payers to ensure accurate and timely reimbursement.

8. Historical information

CPT code 32650 was added to the Current Procedural Terminology system on January 1, 1994. Since its addition, there have been no updates or changes to the code.

9. Examples

1. A patient with recurrent pleural effusion undergoes thoracoscopy with pleurodesis using mechanical irritation.
2. A provider performs thoracoscopy with pleurodesis on a patient with lung cancer to prevent the reaccumulation of fluid in the chest cavity.
3. During a thoracoscopy procedure, the provider uses chemical pleurodesis to treat a patient with mesothelioma.
4. A patient with a history of pleural effusion undergoes thoracoscopy with pleurodesis to prevent further fluid accumulation.
5. A provider performs thoracoscopy with pleurodesis on a patient with tuberculosis to promote lung healing and prevent complications.
6. During a thoracoscopy procedure, the provider mechanically irritates the pleura to induce inflammation and prevent pleural effusion in a patient with congestive heart failure.
7. A patient with a history of recurrent pneumothorax undergoes thoracoscopy with pleurodesis to prevent future episodes.
8. A provider performs thoracoscopy with pleurodesis on a patient with metastatic lung cancer to alleviate symptoms and improve quality of life.
9. During a thoracoscopy procedure, the provider uses chemical pleurodesis to treat a patient with pleural mesothelioma.
10. A patient with a history of pleural effusion undergoes thoracoscopy with pleurodesis to prevent further fluid accumulation and improve respiratory function.