How To Use CPT Code 32653

CPT 32653 describes a thoracoscopy procedure that involves the removal of an intrapleural foreign body or fibrin deposit using a video-assisted endoscopic approach. 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 32653?

CPT 32653 is a code used to describe a thoracoscopy procedure in which a qualified healthcare provider removes a foreign body or fibrin deposit from the area inside the membranes lining the lungs and pulmonary cavity. This procedure is performed using a video-assisted endoscopic approach, allowing the provider to visualize the inside of the patient’s chest on a video monitor.

2. Official Description

The official description of CPT code 32653 is: ‘Thoracoscopy, surgical; with removal of intrapleural foreign body or fibrin deposit.’

3. Procedure

1. After the patient is prepped, draped, and anesthetized, the healthcare provider directs an anesthesiologist to collapse one lung and ventilate the other for the procedure.
2. The provider makes multiple small incisions to enter the pleural cavity and places access ports at each incision site.
3. Using a thoracoscope with a camera and grasping instruments, the provider visualizes the inside of the chest and performs the necessary steps to remove the foreign body or fibrin deposit.
4. The provider irrigates the cavity and collects fibrin and blood clot material for analysis.
5. If any tears occur in the lung during the procedure, the provider closes them.
6. The collapsed lung is expanded again, and the provider identifies and treats any significant air leaks.
7. Chest tubes may be inserted to aid with drainage and lung expansion.
8. The provider removes the instrumentation, confirms adequate lung expansion, and closes the wounds in layers.

4. Qualifying circumstances

CPT 32653 is performed on patients who have intrapleural foreign bodies or fibrin deposits that require removal. The procedure is typically performed by a qualified healthcare provider who is experienced in thoracoscopy and video-assisted endoscopic techniques.

5. When to use CPT code 32653

CPT code 32653 should be used when a thoracoscopy procedure is performed to remove an intrapleural foreign body or fibrin deposit. It is important to ensure that the procedure meets the specific requirements outlined in the code description.

6. Documentation requirements

To support a claim for CPT 32653, the healthcare provider must document the following information:

• Patient’s diagnosis indicating the presence of an intrapleural foreign body or fibrin deposit
• Description of the procedure performed, including details of the removal process
• Date of the procedure
• Start and end time of the procedure
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 32653, ensure that the procedure meets the specific requirements outlined in the code description. It is important to accurately document the procedure and any additional services provided. Consider any applicable modifiers or additional codes that may be necessary to accurately report the procedure.

8. Historical information

CPT 32653 was added to the Current Procedural Terminology system on January 1, 1994. It was later added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A qualified healthcare provider performing a thoracoscopy to remove a foreign body from the pleural cavity of a patient.
2. A patient undergoing a thoracoscopy procedure to remove a fibrin deposit from the membranes lining their lungs.
3. A healthcare provider using video-assisted endoscopic techniques to remove a foreign body from the intrapleural space of a patient.
4. A thoracoscopy procedure performed to remove a fibrin deposit from the pulmonary cavity of a patient.
5. A qualified healthcare provider utilizing a video-assisted approach to remove a foreign body from the area inside the pleural layers of a patient’s lungs.
6. A patient undergoing a thoracoscopy procedure to remove a fibrin deposit from the intrapleural space.
7. A healthcare provider performing a video-assisted endoscopic procedure to remove a foreign body from the membranes lining the patient’s lungs.
8. A thoracoscopy performed to remove a fibrin deposit from the pleural cavity of a patient.
9. A qualified healthcare provider utilizing video-assisted techniques to remove a foreign body from the intrapleural space of a patient.
10. A patient undergoing a thoracoscopy procedure to remove a fibrin deposit from the pulmonary cavity.