How To Use CPT Code 32851

CPT 32851 describes the surgical procedure of lung transplant without the use of cardiopulmonary bypass. 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 32851?

CPT 32851 can be used to describe a surgical procedure in which a single lung is replaced with a healthy lung from a cadaver or living donor. Unlike other lung transplant procedures, this code specifically indicates that the surgery is performed without the use of cardiopulmonary bypass.

2. Official Description

The official description of CPT code 32851 is: ‘Lung transplant, single; without cardiopulmonary bypass.’

3. Procedure

1. The surgical team prepares the patient and places monitoring lines.
2. An incision is made from under the shoulder blade around the chest, ending near the sternum.
3. The provider accesses and removes the diseased lung by dividing the mainstem bronchus at the level of the upper lobe.
4. The two pulmonary veins and single pulmonary artery are divided distally.
5. The healthy lung from the donor is placed into the chest.
6. The provider resects the patient’s mainstem bronchus, pulmonary artery, and pulmonary veins to accommodate the transplant.
7. An end-to-end anastomosis is performed to connect the patient’s structures to the donor structures, including the pulmonary artery, mainstem bronchus, and left atrial cuffs.
8. The provider minimizes the length of both the donor and recipient bronchi to preserve collateral blood supply and achieve overlap of the connecting ends.
9. Donor and recipient soft tissue may be used to cover the anastomosis and close the area.
10. The lung is gently inflated and two chest tubes are inserted.
11. A bronchoscopy is performed to clear remaining blood and mucus from the new lung.
12. The chest is closed in standard fashion.
13. The patient is ventilated and extubated according to standard requirements.

4. Qualifying circumstances

CPT 32851 is used for patients who require a lung transplant without the use of cardiopulmonary bypass. This procedure is typically performed on patients with severe lung disease or damage that cannot be effectively managed through other treatments. The patient must meet the criteria for lung transplantation and be deemed a suitable candidate by the surgical team.

5. When to use CPT code 32851

CPT code 32851 should be used when a single lung transplant is performed without the use of cardiopulmonary bypass. If the procedure involves bilateral lung transplantation or the use of cardiopulmonary bypass, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT 32851, the following documentation should be included:

• Patient’s medical history and indication for lung transplantation
• Description of the surgical procedure performed
• Date of the surgery
• Details of the lung transplant, including the donor source
• Any complications or additional procedures performed
• Post-operative care and follow-up plans

7. Billing guidelines

When billing for CPT 32851, ensure that the procedure was performed without the use of cardiopulmonary bypass. It is important to accurately document the details of the surgery and any additional procedures or complications. CPT code 32851 should not be reported with other lung transplant codes that involve cardiopulmonary bypass.

8. Historical information

CPT 32851 was added to the Current Procedural Terminology system on January 1, 1994. In 2017, it was added to the Inpatient Only (IPO) list for Medicare reimbursement.

9. Examples

1. A patient with end-stage lung disease undergoes a lung transplant without the use of cardiopulmonary bypass.
2. A recipient receives a single lung transplant from a living donor, and the procedure is performed without the use of cardiopulmonary bypass.
3. A patient with severe lung damage due to a chronic respiratory condition undergoes a lung transplant without the use of cardiopulmonary bypass.
4. A lung transplant is performed on a patient with a history of lung cancer, and the procedure is performed without the use of cardiopulmonary bypass.
5. A recipient receives a single lung transplant from a cadaver donor, and the procedure is performed without the use of cardiopulmonary bypass.
6. A patient with cystic fibrosis undergoes a lung transplant without the use of cardiopulmonary bypass.
7. A lung transplant is performed on a patient with pulmonary fibrosis, and the procedure is performed without the use of cardiopulmonary bypass.
8. A recipient receives a single lung transplant from a living donor, and the procedure is performed without the use of cardiopulmonary bypass.
9. A patient with severe emphysema undergoes a lung transplant without the use of cardiopulmonary bypass.
10. A lung transplant is performed on a patient with idiopathic pulmonary arterial hypertension, and the procedure is performed without the use of cardiopulmonary bypass.