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The procedure described by CPT® Code 32810 refers to the closure of the chest wall following an open flap drainage for empyema, specifically known as the Clagett type procedure. Empyema is a collection of pus within the pleural cavity, often resulting from infections such as pneumonia or lung abscesses. In this surgical intervention, the physician first inspects the empyema cavity to ensure it is free from gross infection. If any necrotic or inflamed tissue is present, it is carefully debrided to promote healing. Following this, the cavity is filled with an antibiotic solution to help prevent further infection. The procedure involves the use of a previously created skin flap, which is taken down to allow for closure of the chest wall defect. The physician has several options for closure, which may include using local pleural or intercostal muscle flaps, or more extensive muscle flaps such as those from the serratus anterior or latissimus dorsi muscles. An alternative method involves the use of an omental flap, which can be harvested through either an open or laparoscopic approach and then passed through the diaphragm to fill the empyema cavity. The chosen flap is developed, transposed, and secured over the empyema site, effectively closing the chest wall defect and facilitating recovery.
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The procedure described by CPT® Code 32810 is indicated for patients with empyema, which is characterized by the accumulation of pus in the pleural space. This condition often arises as a complication of pneumonia, lung abscess, or other infections that lead to inflammation and fluid accumulation in the pleural cavity. The Clagett type procedure is specifically performed when there is a need to drain the empyema and subsequently close the chest wall after ensuring that the cavity is free of gross infection.
The Clagett type procedure involves several critical steps to ensure effective closure of the chest wall following the drainage of empyema. Initially, the physician inspects the empyema cavity to confirm that it is free from gross infection. This inspection is crucial as it determines the subsequent steps in the procedure. If any necrotic or inflamed tissue is identified, it is meticulously debrided to promote healing and reduce the risk of infection. After debridement, the cavity is filled with an antibiotic solution, which serves to further prevent infection and facilitate recovery.
After the completion of the Clagett type procedure, post-operative care is essential for recovery. Patients are typically monitored for any signs of infection or complications related to the surgical site. Pain management is also an important aspect of post-procedure care, as patients may experience discomfort following the surgery. The physician may provide specific instructions regarding activity restrictions and wound care to ensure proper healing. Follow-up appointments are necessary to assess the healing process and to address any concerns that may arise during recovery.
| Short Descr | CLOSE CHEST AFTER DRAINAGE | Medium Descr | CLSR CH WALL FLWG OPN FLAP DRG EMPYEMA | Long Descr | Closure of chest wall following open flap drainage for empyema (Clagett type procedure) | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 42 - Other OR therapeutic procedures on respiratory system |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
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