Since there have been few changes with chest tube placement procedure codes, medical coders face a little difficulty in find correct CPT code. Earlier the codes where very clear enough to understand. But, with the revised codes and new codes we have to use them initially carefully, to understand for what procedure they should be coded. Now, let us check out the new and the revised Chest tube placement/insertion CPT code in Interventional radiology facility. These cpt codes for not as difficult to code as Nephrostomy tube placement or Transhepatic cholangiogram procedures. Once you understand them, you can easily code them. CPT code 32556 & 32557 are used for coding chest tube placement procedures.
Thoracostomy is a minimally invasive procedure in which a thin plastic tube is inserted into the pleural space — the area between the chest wall and lungs — and may be attached to a suction device to remove excess fluid or air. A chest tube may also be used to deliver medications into the pleural space.
A pleurodesis procedure is usually performed through a chest tube placed at the time of the thoracentesis.
image courtesy: https://www.nlm.nih.gov/
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Chest tube placement CPT code (thoracostomy) Open procedures
There is only one revised code in this Procedure. CPT code 32551 is earlier used for percutaneous procedure for chest tube placement. But, with the new updates this codes has been revised and now it should be used only for open procedure. But, since this code has now almost deleted in interventional radiology, we have also check the new CPT codes for placement for Chest tube. So, keep in mind that we have separate new procedure codes for chest tube placement, so use 32551 CPT code only for open surgery procedure.
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Description of CPT code 32556 & 32557 for non-tunneled Catheter
Now, we will introduce these new CPT codes 32556 and 32557, which are to be used for chest tube placement for non-tunneled pleural catheter or chest tube placement. It is very important to check whether the catheter is placed in non-tunneled or tunneled, since we have separate codes for each of them. Now, first we will checkout the main difference between these two code 32556 and 32557.
32556 Pleural drainage, percutaneous, with insertion of indwelling catheter; without imaging guidance
32557 with imaging guidance
With the above description for CPT code for Chest tube placement, it will very clear the main difference between them and that is the use of imaging guidance. So, check the presence or use of imaging guidance for coding chest tube placement cpt code.
List of Conditions treated with thoracostomy
- Pneumothorax
- Pleural Effusion
- Empyema
- Hemothorax
Related Procedure codes for Chest region
● 32554 Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance
● 32555 Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance
The above procedure codes will be used when a needle or a catheter is used to gain access into the chest and drain the fluid, but a tube/catheter is not left in place at the end of the case. CPT code 32554 and 32555 are used to report such procedures.
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CPT code for Chest tube Placement for Tunneled Catheter
As I mentioned previously, we have separate code for non-tunneled and tunneled catheter for chest tube placement. So, for placement of indwelling tunneled pleural catheter with cuff in chest we use CPT code 32550. So, be careful using this CPT code, which is supposed to be used only for tunneled placed chest tube catheters.
Tunneled pleural catheters also have a “cuff” that secures them underneath the skin so the mention of a “cuff”in the note is an additional clue you may be looking at a tunneled pleural catheter. Finally, Pleurx is a notable trade name for a tunneled pleural catheter so if your note indicates a Pleurx catheter insertion, you are looking at a tunneled pleural catheter.
Codes 32551, 32556, and 32557 are also used for pleural abscess or empyema drainage. These codes are for placement of indwelling catheters.
Report the appropriate E&M code for removal of an indwelling non-tunneled chest drainage catheter.
Report the appropriate E&M code for removal of fluid from the pleural space via a pre-existing drainage catheter.
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