How To Use CPT Code 32668

CPT 32668 describes a thoracoscopy procedure that involves the visual examination of the chest cavity and the removal of multiple sections of the lung for diagnostic and therapeutic purposes. 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 32668?

CPT 32668 is a code used to describe a thoracoscopy procedure that involves the visual examination of the chest cavity and the removal of more than one section of the lung for diagnostic and therapeutic purposes. This procedure is typically performed by a healthcare provider to diagnose or treat lung cancer. During the procedure, the provider makes incisions in the chest and inserts a trocar, or port, to hold instruments used during the procedure. The provider then uses an endoscope with a video camera attached to visualize the chest cavity and performs various surgical techniques to remove sections of the lung.

2. Official Description

The official description of CPT code 32668 is: ‘Thoracoscopy, surgical; with diagnostic wedge resection followed by anatomic lung resection (List separately in addition to code for primary procedure).’ This code should be reported in conjunction with the primary procedure code for the thoracoscopy.

3. Procedure

1. During a thoracoscopy procedure, the healthcare provider makes incisions in the chest to access the chest cavity.
2. A trocar, or port, is inserted through one of the incisions to hold instruments used during the procedure.
3. The provider partially collapses the lung by passing air through the trocar, allowing for better visualization of the area to be treated.
4. An endoscope, either flexible or rigid, with a video camera attached is inserted through the trocar to visualize the chest cavity.
5. Additional trocars may be inserted to allow for the insertion of other operating instruments.
6. The provider clamps and cuts bronchial tubes and blood vessels connected to the sections of the lung that will be removed.
7. Sections of the lung are excised, and the area where the sections were removed is sutured.
8. The trocars and endoscope are removed, and a chest tube may be inserted to drain the wound and re-expand the lung.

4. Qualifying circumstances

CPT 32668 is typically performed on patients who require a diagnostic wedge resection followed by anatomic lung resection. This procedure is commonly used for the diagnosis or treatment of lung cancer. It is important to note that CPT 32668 should be reported in addition to the primary procedure code for the thoracoscopy.

5. When to use CPT code 32668

CPT code 32668 should be used when a thoracoscopy procedure is performed, and it involves a diagnostic wedge resection followed by anatomic lung resection. This code should be reported in addition to the primary procedure code for the thoracoscopy.

6. Documentation requirements

To support a claim for CPT 32668, the healthcare provider must document the following information:

• Indication for the thoracoscopy procedure
• Details of the diagnostic wedge resection and anatomic lung resection
• Date of the procedure
• Start and end time of the procedure
• Any complications or unexpected findings during the procedure
• Any additional procedures performed during the thoracoscopy
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 32668, ensure that the procedure meets the criteria for a thoracoscopy with diagnostic wedge resection followed by anatomic lung resection. This code should be reported in addition to the primary procedure code for the thoracoscopy. It is important to review the specific billing guidelines and requirements of the payer to ensure accurate and appropriate billing.

8. Historical information

CPT 32668 was added to the Current Procedural Terminology system on January 1, 2012. It was later added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A healthcare provider performs a thoracoscopy with diagnostic wedge resection followed by anatomic lung resection to diagnose and treat lung cancer in a patient.
2. During a thoracoscopy procedure, a provider removes multiple sections of the lung for diagnostic and therapeutic purposes in a patient with suspected lung cancer.
3. A thoracoscopy with diagnostic wedge resection followed by anatomic lung resection is performed to remove sections of the lung affected by a tumor in a patient.
4. A healthcare provider utilizes a thoracoscopy with diagnostic wedge resection followed by anatomic lung resection to diagnose and treat a patient with a lung infection.
5. During a thoracoscopy procedure, a provider performs a diagnostic wedge resection followed by anatomic lung resection to remove sections of the lung affected by a non-cancerous condition in a patient.
6. A healthcare provider performs a thoracoscopy with diagnostic wedge resection followed by anatomic lung resection to remove sections of the lung affected by a benign tumor in a patient.
7. During a thoracoscopy procedure, a provider performs a diagnostic wedge resection followed by anatomic lung resection to remove sections of the lung affected by a lung abscess in a patient.
8. A thoracoscopy with diagnostic wedge resection followed by anatomic lung resection is performed to remove sections of the lung affected by a lung cyst in a patient.