How To Use CPT Code 32815

CPT 32815 describes the open closure of a major bronchial fistula, which is an abnormal passage or communicating tract between a bronchus and another body part. 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 32815?

CPT 32815 can be used to describe the surgical closure of a major bronchial fistula. This procedure involves the provider blocking the abnormal passage or communicating tract between a bronchus and another body part, such as the pleural surface of the lung or cutaneous surface of the thoracic wall. The closure is performed through an incision without disturbing the lung to chest wall relation. The provider creates a pedunculated flap from adjacent tissue and inserts it into the bronchus to block it. The sides of the flap are sutured to tissues in the adjacent area to prevent dislodgment. Drainage tubes and/or packing may be required before the final closure of the operative wound.

2. Official Description

The official description of CPT code 32815 is: ‘Open closure of major bronchial fistula.’

3. Procedure

1. The surgical team preps and drapes the patient.
2. The provider exposes the fistula through an incision without disturbing the lung to chest wall relation.
3. A strip of tissue is dissected from adjacent tissue and fashioned into a pedunculated flap.
4. The free end of the flap is inserted into the bronchus to block it.
5. The sides of the flap are sutured to tissues in the adjacent area to prevent dislodgment.
6. Drainage tubes and/or packing may be required before the final closure of the operative wound.

4. Qualifying circumstances

CPT 32815 is used for the closure of major bronchial fistulas, which can be either bronchopleural (joining of a bronchial tube and the pleura) or bronchocutaneous (joining of the bronchus, pleural space, and subcutaneous tissue). This code applies to the closure of either type of fistula.

5. When to use CPT code 32815

CPT code 32815 should be used when the provider performs the open closure of a major bronchial fistula. It is important to note that this code is not appropriate for other types of fistula closures or procedures.

6. Documentation requirements

To support a claim for CPT 32815, the provider must document the following information:

• Description of the major bronchial fistula and the need for closure
• Details of the surgical procedure performed, including the creation and insertion of the pedunculated flap
• Use of drainage tubes and/or packing, if applicable
• Final closure of the operative wound
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 32815, ensure that the procedure performed is the open closure of a major bronchial fistula. It is important to follow the specific documentation requirements and guidelines for this code. There are no specific guidelines regarding reporting CPT 32815 with other codes.

8. Historical information

CPT 32815 was added to the Current Procedural Terminology system on January 1, 1990. The code has not undergone any updates since its addition. However, it is important to stay updated with any changes or revisions to the code in future editions.

9. Examples

1. A patient with a bronchopleural fistula undergoes open closure of the fistula to prevent air leakage and improve lung function.
2. A major bronchial fistula between a bronchus and the pleural surface of the lung is surgically closed to prevent infection and promote healing.
3. A patient with a bronchocutaneous fistula undergoes open closure of the fistula to restore normal respiratory function and prevent complications.
4. The provider performs the open closure of a major bronchial fistula in a patient who experienced persistent coughing and respiratory distress.
5. A bronchopleural fistula is surgically closed in a patient who developed it as a complication of a previous lung surgery.
6. A major bronchial fistula is closed to prevent the leakage of air and fluid into the pleural space, reducing the risk of infection.
7. The provider performs the open closure of a bronchocutaneous fistula in a patient with a history of thoracic trauma.
8. A patient with a bronchopleural fistula undergoes surgical closure to improve lung function and prevent recurrent infections.
9. The open closure of a major bronchial fistula is performed in a patient with a history of lung cancer and previous lung resection.
10. A bronchocutaneous fistula is surgically closed in a patient who developed it as a complication of a chest tube insertion.