How To Use CPT Code 32852

CPT 32852 describes the surgical procedure of lung transplantation, specifically the replacement of a single lung with a healthy lung from a cadaver or living donor, using 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 32852?

CPT 32852 can be used to describe the surgical procedure of lung transplantation, where a single lung is replaced with a healthy lung from a cadaver or living donor. This procedure involves the use of cardiopulmonary bypass to temporarily take over the function of the heart and lungs during the surgery.

2. Official Description

The official description of CPT code 32852 is: ‘Lung transplant, single; with 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. If the patient’s hemodynamics deteriorate, cardiopulmonary bypass is initiated.
6. The provider cannulates the atrium and perfuses the femoral artery, placing the patient on cardiopulmonary bypass.
7. The healthy lung from a cadaver or living donor is placed into the chest.
8. The provider resects the patient’s mainstem bronchus, pulmonary artery, and pulmonary veins to accommodate the transplant.
9. An end-to-end anastomosis is performed to connect the patient’s respective structures to the donor structures, including the pulmonary artery, mainstem bronchus, and left atrial cuffs.
10. The provider minimizes the length of both the donor and recipient bronchi to preserve collateral blood supply and achieve overlap of the connecting ends.
11. Donor and recipient soft tissue may be used to cover the anastomosis and close the area.
12. The lung is gently inflated, and two chest tubes are inserted.
13. The cardiopulmonary bypass is discontinued, including the removal of the cannulas.
14. A bronchoscopy is performed in the operating room to clear remaining blood and mucus from the new lung.
15. The chest is closed in standard fashion, and the patient is ventilated and extubated according to standard requirements.