On Demand: Cardiothoracic Series 2: Coding for Thoracic Procedures-Q&A

Q&A

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The 2024 MedAxiom document provides guidance on coding for various thoracic procedures. Below is a summary of the provided Q&A:<br /><br />1. **Transbronchial Needle Aspiration**: CPT code 31629 is correct if performed on a lung lobe.<br /><br />2. **Fiberoptic Bronchoscopy**: CPT code 31622 is billable when no significant issues are found and an EZ blocker is placed.<br /><br />3. **VATS Lobectomy and Bronchoplasty**: There's no specific code for VATS bronchoplasty, so use an unlisted code.<br /><br />4. **Chest Incision and Closure**: Do not reduce procedure codes if the incision is left open; use a 58 modifier for the subsequent closure.<br /><br />5. **CPT Code 32120**: This code pertains to any post-operative complication.<br /><br />6. **Lung Decortication**: There's no official note from STS on billing over 50% decortication as total. Physician documentation should clarify if the procedure is partial or total.<br /><br />7. **Bronchoscopy with Lavage**: Typically included in lung transplants; documentation is essential for billing separately.<br /><br />8. **CPT Codes 32653 and 36252**: Normally not reported together unless done in separate anatomic locations.<br /><br />9. **EGD Before Procedures**: If it serves a diagnostic purpose and has supportive documentation, it may be billable separately from the major procedure.<br /><br />10. **VATS Apical Pleurectomy**: Code with 32656, as the apical section is part of the parietal pleura.<br /><br />11. **VATS Drainage of Empyema**: No specific code exists. Use an unlisted code and consult your provider for comparable procedures.<br /><br />12. **Mediastinal Lymph Node Removal**: For stand-alone removal without a primary procedure, use an unlisted code.<br /><br />The document emphasizes the importance of precise documentation and suggests consulting with providers for comparable procedures when using unlisted codes.

Keywords

MedAxiom 2024

thoracic procedures

CPT code 31629

fiberoptic bronchoscopy

VATS lobectomy

chest incision

lung decortication

bronchoscopy with lavage

EGD diagnostic

mediastinal lymph node