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This procedure is reported with 32609, one time only, even if multiple biopsies are obtained. Per the Medicare Physician Fee Schedule Database (MPFSDB), modifier 50 does not apply to this code. Surgical VATS codes include pleurodesis, resections, lobectomy, segmentectomy, pneumonectomy, and lung volume reduction.
Surgical VATS. Add-on code +32667 Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass or nodule), each additional resection, ipsilateral (List separately in addition to code for primary procedure) describes additional thoracoscopic therapeutic wedge resections performed during the same operative session.
J94 ICD-10-CM Diagnosis Code J94. Other pleural conditions 2016 2017 2018 2019 Non-Billable/Non-Specific Code. Type 1 Excludes pleurisy NOS (R09.1) traumatic hemopneumothorax (S27.2) traumatic hemothorax (S27.1) tuberculous pleural conditions (current disease) (A15.-) Other pleural conditions.
Following the VATS, a chest tube may be left in the operative pleural cavity for drainage and/or lung re-expansion. Multiple procedures can be performed using VATS to treat an assortment of disorders. For example: Biopsies. Lung nodules.
By Laurette Pitman, RN, CPC-H, CGIC, CCS#N#Due to advances in surgical procedures, video-assisted thoracoscopic surgery (VATS) has an increasing role in the diagnosis and treatment of a wide variety of thoracic disorders that previously required sternotomy or open thoracotomy. Patients who undergo this procedure have the advantages of less postoperative pain, fewer surgical complications, a shortened hospital stay, and reduced costs.#N#The procedure is performed with the use of small fiber optic cameras that allow the surgeon to look inside the chest, usually via a monitor. Similar to a laparoscopic procedure, small incisions are made in the chest allowing the surgeon to introduce the thoracoscope and other small instruments, which may be used for cutting, stitching, or stapling. Following the VATS, a chest tube may be left in the operative pleural cavity for drainage and/or lung re-expansion.#N#Multiple procedures can be performed using VATS to treat an assortment of disorders. For example:#N#Biopsies
Surgical VATS codes include pleurodesis, resections, lobectomy, segmentectomy, pneumonectomy, and lung volume reduction. Medicare has designated these as inpatient-only procedures (status indicator C); you would not expect to see these procedures in the outpatient setting.#N#Pleurodesis is accomplished to artificially obliterate the pleural space and prevent the recurrence of pneumothorax or pleural effusions. This procedure can be done either chemically or mechanically. In a chemical pleurodesis, a substance such as bleomycin, tetracycline, povidone iodine, or a talc slurry is introduced into the pleural space. This results in an irritation between the pariental and visceral layers of the pleura and closes off the pleural space. In the mechanical method, the pleura are irritated, typically with a piece of rolled-up Marlex mesh mounted at the end of an endoscopic grasper. Performed chemically or mechanically, the procedure is reported with 32650 Thoracoscopy, surgical; with pleurodesis (eg, mechanical or chemical).#N#CPT® codes 32666-32668 describe diagnostic and therapeutic wedge resections. A wedge resection involves the surgical removal of a wedge-shaped portion of tissue from one or both lungs, and is usually performed for the diagnosis or treatment of small lung nodules. CPT® 32666 Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass, nodule), initial unilateral is reported for an initial unilateral therapeutic wedge resection of a mass or nodule. Modifier 50 is appended for bilateral procedures. Add-on code +32667 Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass or nodule), each additional resection, ipsilateral (List separately in addition to code for primary procedure) describes additional thoracoscopic therapeutic wedge resections performed during the same operative session.#N#When a VATS diagnostic wedge resection is followed by an anatomic lung resection, add-on code +32668 Thoracoscopy, surgical; with diagnostic wedge resection followed by anatomic lung resection (List separately in addition to code for primary procedure) is reported. Pay special attention to the parenthetical note following 32668, which identifies allowable primary procedure codes.
CPT® codes 32607 Thoracoscopy; with diagnostic biopsy (ies) of lung infiltrate (s) (eg, wedge, incisional), unilateral, 32608 Thoracoscopy; with diagnostic biopsy (ies) of lung nodule (s) or mass (es) (eg, wedge, incisional), unilateral, and 32609 Thoracoscopy; with biopsy (ies) of pleura identify thoracoscopic biopsy procedures. A diagnostic biopsy or biopsies of lung infiltrate—whether by wedge or incisional technique—is reported using 32607. If the thoracoscopic biopsy is performed on a lung nodule or mass (again, either wedge or incisional), select 32608. Both 32607 and 32608 are unilateral codes, reported only once per lung; procedures performed on both lungs require the use of modifier 50 Bilateral procedure.
A diagnostic biopsy or biopsies of lung infiltrate—whether by wedge or incisional technique—is reported using 32607. If the thoracoscopic biopsy is performed on a lung nodule or mass (again, either wedge or incisional), select 32608. Both 32607 and 32608 are unilateral codes, reported only once per lung; procedures performed on both lungs require ...
VATS lobectomy is a surgical procedure that removes one lobe of the lung that contains cancerous cells. As in a lobectomy performed via thoracotomy, the VATS procedure dissects, ligates, and divides the pulmonary artery, pulmonary vein, and bronchus to the involved pulmonary lobe.
Performed chemically or mechanically, the procedure is reported with 32650 Thoracoscopy, surgical; with pleurodesis (eg, mechanical or chemical).