How To Use CPT Code 32850

CPT 32850 describes the procedure for donor pneumonectomy(s) from a cadaver donor, including cold preservation. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 32850?

CPT 32850 can be used to describe the surgical procedure of removing one or both lungs from a deceased donor for transplantation. This code also includes the cold preservation of the lung(s) to maintain their viability for transplantation.

2. Official Description

The official description of CPT code 32850 is: ‘Donor pneumonectomy(s) (including cold preservation), from cadaver donor.’

3. Procedure

1. The retrieval team accesses the pleural cavity, typically through a median sternotomy, to gain access to the lungs.
2. The provider assesses the condition of the lungs and begins the process of cooling them to minimize cellular metabolism and function.
3. Various techniques may be used to ensure rapid cooling and preservation of the lungs, such as topical cooling, flushing the pulmonary artery with a low-temperature preservation fluid, administering prostaglandin to maintain microcirculation, and flushing the veins to remove clots of blood or fat.
4. The provider surgically increases the pressure across the alveoli and intrapleural space to expand any collapsed areas of the lung.
5. The trachea is stapled and divided prior to the separation of the lung from the donor for storage.
6. The provider selects a method of preservation, such as hypothermic, hyperbaric, or hypothermic pulsatile or nonpulsatile perfusion, to maintain the lung(s) until transplantation.

4. Qualifying circumstances

CPT 32850 is performed when a lung or lungs are being retrieved from a cadaver donor for transplantation. The procedure is typically performed by a surgical team specializing in organ transplantation. The lung(s) must be preserved using cold preservation techniques to maintain their viability for transplantation.

5. When to use CPT code 32850

CPT code 32850 should be used when a provider performs a donor pneumonectomy(s) from a cadaver donor and includes the cold preservation of the lung(s) for transplantation. This code should not be used for other lung transplantation procedures or when the lung(s) are not being preserved for transplantation.

6. Documentation requirements

To support a claim for CPT 32850, the provider must document the following information:

• Details of the procedure, including the approach used for accessing the pleural cavity
• Assessment findings of the lungs
• Specific techniques used for cooling and preserving the lungs
• Description of any additional procedures performed, such as increasing pressure across the alveoli or stapling and dividing the trachea
• Method of preservation chosen
• Duration of the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 32850, ensure that the procedure involves the removal of lung(s) from a cadaver donor and includes the cold preservation of the lung(s) for transplantation. It is important to follow any specific billing guidelines provided by the payer or Medicare. Additionally, be aware of any other codes that may need to be reported in conjunction with CPT 32850, such as codes for initiation and monitoring of marginal cadaver donor lung(s) organ perfusion system.

8. Historical information

CPT 32850 was added to the Current Procedural Terminology system on January 1, 1994. There have been a few changes to the code since its addition, including updates to the code description and the addition of the code to the Inpatient Only (IPO) list in 2017.

9. Examples

1. A surgical team performing a donor pneumonectomy from a cadaver donor and preserving the lung(s) for transplantation.
2. A provider accessing the pleural cavity through a clamshell approach to retrieve the lung(s) from a cadaver donor and cool them for transplantation.
3. A surgeon using hypothermic pulsatile perfusion to preserve the lung(s) after a donor pneumonectomy from a cadaver donor.
4. A transplant team performing a donor pneumonectomy and utilizing hyperbaric preservation techniques for the lung(s) from a cadaver donor.
5. A provider performing a donor pneumonectomy and using a combination of cooling methods, such as topical cooling and hypothermic nonpulsatile perfusion, to preserve the lung(s) for transplantation.
6. A surgical team performing a donor pneumonectomy and utilizing prostaglandin administration to maintain microcirculation during the preservation of the lung(s) from a cadaver donor.
7. A provider performing a donor pneumonectomy and flushing the veins to remove clots of blood or fat before preserving the lung(s) for transplantation.
8. A surgeon performing a donor pneumonectomy and surgically increasing the pressure across the alveoli and intrapleural space to expand collapsed areas of the lung(s) before preservation.
9. A transplant team performing a donor pneumonectomy and using hypothermic pulsatile perfusion to preserve the lung(s) for transplantation.
10. A provider performing a donor pneumonectomy and selecting hypothermic preservation techniques to maintain the lung(s) until transplantation.