How To Use CPT Code 32666

CPT 32666 describes a specific procedure that involves the visual examination of the chest cavity and the removal of a section of the lung where a mass or nodule is located. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 32666?

CPT 32666 is a code used to describe a surgical procedure known as thoracoscopy with therapeutic wedge resection. This procedure involves the use of a video-assisted thoracic surgery (VATS) to visually examine the chest cavity and remove a section of the lung where a mass or nodule is located. It is important to note that this code should only be used for the initial unilateral resection, and if the procedure is performed bilaterally, modifier 50 should be appended to the code.

2. Official Description

The official description of CPT code 32666 is: ‘Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass, nodule), initial unilateral.’ It is important to note that this code should not be reported in conjunction with codes 32440, 32442, 32445, 32488, or 32671.

3. Procedure

1. The provider begins by making an incision in the chest and inserting a trocar, or port, to hold the instruments used during the procedure.
2. A partial collapse of the lung is achieved by passing air through the trocar, allowing the provider to visualize the area to be treated.
3. A flexible or rigid endoscope, equipped with a video camera, is inserted into the trocar to provide a clear view of the chest cavity.
4. Additional trocars are placed in the chest cavity to allow the provider to insert operating instruments.
5. The provider clamps and cuts bronchial tubes and blood vessels connected to the section of the lung that will be removed, which is shaped like a wedge.
6. The wedge-shaped section of the lung is excised, and the area where it was removed is sutured.
7. The trocars and endoscope are removed, and a chest tube is inserted to drain the wound and re-expand the lung.

4. Qualifying circumstances

CPT 32666 is typically performed to treat lung cancer. It is important to note that this procedure should only be performed by a qualified healthcare provider. The patient must meet the necessary criteria for the procedure, and the provider must determine that a therapeutic wedge resection is the appropriate course of action. It is also important to ensure that the procedure is not performed in conjunction with other specific codes, as mentioned in the official description.

5. When to use CPT code 32666

CPT code 32666 should be used when a provider performs a thoracoscopy with therapeutic wedge resection for the initial unilateral removal of a mass or nodule in the lung. It is important to note that this code should not be used for subsequent resections on the same side. If additional resections are performed, CPT code 32667 should be used.

6. Documentation requirements

To support a claim for CPT code 32666, the provider must document the following information:

• Patient’s diagnosis and the need for therapeutic wedge resection
• Details of the procedure, including the use of thoracoscopy and the specific techniques employed
• Date of the procedure
• Any complications or unexpected findings during the procedure
• Details of the resection, including the size and location of the mass or nodule
• Any additional procedures performed during the same session
• Signature of the performing provider

7. Billing guidelines

When billing for CPT code 32666, it is important to ensure that the procedure meets the necessary criteria and is performed by a qualified healthcare provider. Modifier 50 should be appended to the code if the procedure is performed bilaterally. It is also important to avoid reporting this code in conjunction with specific other codes, as mentioned in the official description. Additionally, it is crucial to follow any specific billing guidelines provided by the payer or relevant coding guidelines.

8. Historical information

CPT code 32666 was added to the Current Procedural Terminology system on January 1, 2012. Since its addition, there have been no updates or changes to the code.

9. Examples

1. A provider performs a thoracoscopy with therapeutic wedge resection to remove a mass in the lung of a patient with suspected lung cancer.
2. During a thoracoscopy, a provider identifies a nodule in the lung and performs a therapeutic wedge resection to remove it.
3. A patient undergoes a thoracoscopy with therapeutic wedge resection to remove a suspicious mass found during a routine chest X-ray.
4. A provider performs a therapeutic wedge resection on a patient with a known lung nodule to determine if it is cancerous.
5. During a thoracoscopy, a provider discovers a mass in the lung and performs a therapeutic wedge resection to remove it for further analysis.
6. A patient with a history of lung cancer undergoes a thoracoscopy with therapeutic wedge resection to remove a recurrent mass in the lung.
7. A provider performs a therapeutic wedge resection on a patient with a lung nodule to alleviate symptoms and improve lung function.
8. During a thoracoscopy, a provider identifies a suspicious mass in the lung and performs a therapeutic wedge resection to obtain a tissue sample for biopsy.
9. A patient with a known lung nodule undergoes a thoracoscopy with therapeutic wedge resection to remove the nodule and prevent potential complications.