Thoracentesis CPT Code (2022) Description, Guidelines, Reimbursement, Modifiers & Examples

Thoracentesis CPT code 32554 and CPT 32555 may indicate thoracentesis procedures with or without a picture. A needle or catheter is introduced into the pleural area to draw blood during a thoracentesis.

Summary & Descriptions

The fluid (blood or pus) accumulated between the pleura and the chest wall evacuates during a thoracentesis. The diagnostic thoracentesis procedure will use to determine the source of the fluid buildup. At the same time, the therapeutic thoracentesis procedure will use to alleviate the symptoms.

The official description of CPT 32555 is: “Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance.“

The official description of CPT 32556 is: “Pleural drainage, percutaneous, with insertion of indwelling catheter; without imaging guidance.“

Aspiration of fluid from the pleural area with a needle or catheter may classify as CPT 32555. Upon completion of the procedure, the catheter or needle will discard. A non-tunneled chest tube for drainage into the pleural space, part number CPT 32557, is required for insertion and will stay in the pleural space.

Aside from using picture guidance apps, apps are becoming increasingly vital. With reduced reimbursement for several processes in procedural radiology, an APP can provide a significant cost-benefit.

 The physician can remove fluid, blood, or air from a distance between the lungs and the chest wall with a needle or catheter. We may use imaging guidance to carry out the procedure.

In CTP code 32555, fluid, blood, or air will remove from the space between the lungs and the chest wall with a needle or catheter by the physician. He performs the procedure under the supervision of imaging.

CPT 32557: insertion of an indwelling catheter guided by imaging during percutaneous pleural drainage. 

Under the new CPT codes that went into effect in 2012, chest drainage with a catheter (CPT 32551) may now design as an open procedure.

• When a pleural drainage tube inserts perceptually, it can record CPT 32556 or CPT 32557.
• Imaging instructions include codes CPT 32555 and CPT 32557 (fluoroscopic, ultrasonography, CT, or MRI)

Procedure codes such as CPT 32556 and CPT 32554 will code with caution. The four guidance codes supported or coded with these procedural codes are listed below.

Needle placement with ultrasonic guidance (e.g., biopsy, aspiration, injection, localization device), supervision, and interpretation of imaging

Needle placement using fluoroscopic guidance (e.g., biopsy, aspiration, injection, localization device) (list separately in addition to the code for primary procedure)

For needle placement, compound tomography is used as guidance (e.g., biopsy, injection, localization device), supervision, and imaging interpretation.

Needle placement using magnetic resonance guidance (e.g., biopsy, aspiration, injection, and localization device), monitoring and understanding of radiological images

CPT 32554 – 32557 will not report in conjunction with CPT 32550, CPT 32551, CPT 76942 (ultrasound guidance), or CPT 77002 (computed tomography)

Explanation Of The CPT Codes For Thoracentesis

The phrase “with insertion of indwelling catheter” comes during the CTP explanation for these codes, referring to whether or not the catheter may leave in place after draining. It is essential to include in the CTP description since CPT codes 32556 and 32557 are necessary when a percutaneous chest tube will implant.

CPT number 32551 will use for an abscess, empyema, or hem thorax to treat by using a tube thoracotomy. CPT code 32551 is a “distinct procedure,” according to the CPT code descriptor. It is unnecessary to report it separately when performed on the same patient as another open thoracic surgery unless it may do in the opposite thoracic cavity from the one used for available thoracic therapy.

It is usual practice to perform a chest radiologic examination after a chest tube insertion procedure (e.g., CPT codes 32550, 32551, 32554, and 32555) to check that the chest tube is positioned correctly. This radiologic examination does not need a chest radiology CPT code (e.g., CPT 71010).

It will record using Modifier 59. Code CPT 71020 and modifier 59 should not be used for a post-intubation chest x-ray to confirm that the tube may position appropriately.

A needle or catheter may penetrate the pleural region and aspirate fluid during this treatment. The catheter or syringe may then remove from the patient. CTP 32557 may use for a non-tunneled chest tube to be introduced and remain in the pleural area for the duration of the procedure 

Current guidelines state that the CPT 32551 and CPT 32554 procedures (which do not use imaging guidance) and CPT 32555 methods (which do) use a percutaneous needle or catheter to aspirate anything out of the lung’s pleural space.

Still, these devices may remove before a patient leaves the hospital or will admit. If you had used CPT 32421 or CPT 32422 (with or without advisory codes), CPT 32554 or CPT 32555 would be the same as CPT 32554 in 2013.

There is no direction. If a catheter is placed percutaneous and remains in for a lengthy period, CPT 32556 and imaging CPT 32557 will be employed (but not tunneled). If you previously coded CPT 32551 (CPT 75989), the 2013 codes are CPT 32556 (or CPT 32557). (CPT 75989).

CPT 32000 may be used for a first or subsequent episode of thoracentesis, a pleural cavity puncture for aspiration. CPT 32002 is the code for a pneumothorax thoracentesis with tube insertion and water seal.

Billing Guidelines

Use CPT’s radiology department if you require imaging services during either of these operations. CPT 76003, CPT 76360, or CPT 76942 may use to bill for fluoroscopy, CT, or ultrasound in conjunction with the following two procedures.

Pleural effusions can diagnose using imaging tests and inserting a needle, which is what a thoracentesis operation entails. It may only recommend using the CPT 76942 for procedures such as biopsy, injection, and aspiration.

Add modifier 50 (bilateral procedure) to CPT 32555 to indicate that the clinician should perform thoracentesis on both sides of the patient’s pleural space. Following that, all biopsies, spinal injections, and aspiration surgeries on the patient may perform using the CPT 76942 ultrasound guidance.

Only non-anesthetic operations are eligible for the Hospital Outpatient Prospective Payment System’s limited procedure modifier -52. The modifier -74 should be used instead of the modifier -52 for limited treatments needing anesthesia. 

Modifier -52 reduces the mobile payment categorization payment by 50%; modifier -74 does not; this is critical information. The operation (CPT 93975) cannot record unless both steps will complete. Instead, CPT 93976 may use as the procedure code for reporting.

Using Modifiers With The Thoracentesis CPT Codes

You do not need to use a multiple procedure modifier for CPT 32000 and CPT 32002 to invoice them alongside other operations because they are exempt from modifier -51. A tube may place through the thorax for CPT 32020.

As a result, CPT code 31500 can now be paid independently of CPT codes 32000, CPT 32002, and CPT 32020, which is fantastic news. Although modifier -51 is not necessary for the previous codes, further modifiers may require for these respiratory treatments. 

Reimbursement

Thoracentesis (fluid evacuation from the peritoneal cavity) costs an average of $1,454 in cash across all locations. Medicare eventually revised its policies and stopped covering emergency room elective thoracentesis. 

Regardless of the hospital’s agreement, the patient may force to use ultrasound guidance whether or not the therapy requires it. The hospital successfully merged the thoracentesis treatment with an outpatient operation and ultrasound imaging. The hospital benefited from the high outpatient surgery fee and the technical price for the odd unnecessary scan. 

Billing Example

The patient may sit upright in the angiographic suite for the procedure. Finally, an ultrasound performs on the right side of the patient’s abdomen. One percent of lidocaine may inject after an appropriate entry point will discover.

A sheathed needle may insert into the pleural space under direct sonographic guidance. PACS saves with a persistent access image of the hand entering the effusion simultaneously with real-time ultrasonography.

After that, the tubing may attach to the catheter hub and the latter to the suction. When the catheter may insert, 680 milliliters of yellow serous fluid may evacuate. After the tube removes, a sterile dressing was applied. There were no immediate difficulties with the patient’s treatment, and he may take to the hospital for further evaluation.