Most Common Thoracic Surgery CPT Codes

Choosing the accurate code from so many thoracic surgical procedure codes can be overwhelming! But not if you carefully review the descriptors of the CPT codes and pick the ones that describe the rendered services precisely. Yes, we understand that for some thoracic surgeons, trying to handle their medical billing activities, such as charge entry and payment posting, is easier said than done.

Thus, in this guide, we will discuss the thoracic surgery CPT codes for the most rendered procedures and services and provide real-world examples for better understanding. But before we dive into the coding details, let’s first quickly understand what thoracic surgery actually entails!

What is Thoracic Surgery?

A thoracic surgery can be referred to as any operation within your chest (thorax). Yes, the heart is the best-known organ in the chest, but it does not mean that the thoracic procedures have everything to do with just one organ. In fact, it may include surgical procedures related to the lung, windpipe (trachea), the area between your lungs (mediastinum), food pipe (esophagus), diaphragm, and the chest wall (breastbone, ribs, and muscles around them).

A thoracic surgeon may perform surgery using either a minimally invasive approach (making smaller incisions and placing a camera) or utilizing an open approach (involving larger incisions). Regardless of the approach, thoracic surgeries can treat a number of issues related to the upper abdomen and chest, including but not limited to heart failure, lung cancer, hiatal hernias,  stretched blood vessels, etc.

Common Thoracic Surgery CPT Codes

Discussed below are the most commonly used thoracic surgery CPT codes, along with their applicable scenarios to better understand the complexity and scope of the procedures:

CPT Code 32096 – Lung Infiltrate Biopsy

A physician referred a patient with a severe and constant cough to a thoracic surgeon when the imaging studies revealed suspicious lung infiltrates. The surgeon performed an open thoracotomy to gain access to the affected area of the lung and performed a biopsy – i.e., obtained multiple specimens from the affected lung tissue for pathological examination.

Since the 32096 CPT code for thoracic surgery specifically describes the rendered services, the provider may report it to receive rightful payment from the payer.

CPT Code 32491 – Lung Volume Reduction Surgery

The 32491 thoracic surgery CPT code involves surgically removing the diseased emphysematous lung tissue by accessing the lung via a transthoracic or sternal split approach.

Here’s a scenario where a surgeon may render this procedure. A patient with severe emphysema experienced breathing issues and exercise intolerance despite effective medical management. Upon requesting the lung function test, it was revealed that the lung had hyperinflation and air trapping. 

As a result, the surgeon performed lung volume reduction surgery to improve the patient’s lung function and enhance quality of life. It involved accessing the diseased lung area via an open thoracotomy approach to remove a portion of damaged lung tissue, allowing the healthy lung tissue to expand effectively.

CPT Code 32604 – Pericardial Sac Biopsy

This CPT code for thoracic surgery involves utilizing an endoscope to visualize the thorax for taking the pericardial sac sample for pathological evaluation.

Let’s consider a scenario! A patient complained of persistent shortness of breath and chest pain. Thus, the thoracic surgeon rendered pericardiocentesis to visualize the pericardial sac and obtain a fluid sample using an endoscope for diagnostic analysis. Here, thoracic surgery  CPT code 32604 will apply for accurate reimbursements.

CPT Code 32607 – Multiple Lung Nodule Resection

You may use this thoracic surgery CPT code to bill a video-assisted endoscopic approach when the surgeon takes one or more samples involving one or more abnormal substances in a single lung.

For instance, a patient with a constant cough visited the thoracic surgeon with various imaging studies. The images revealed multiple suspicious nodules in the right lung. Thus, the surgeon resected these suspicious nodules in the right lung by performing a video-assisted thoracoscopic surgery.

CPT Code 32650 – Pleurodesis

Assume a patient with lung cancer experienced recurrent pleural effusions, resulting in severe breathing issues. Thus, the thoracic surgeon performed a thoracoscopy to prevent further fluid accumulation. That is, the surgeon visualized the pleural space using an endoscope to introduce a sclerosing agent to induce inflammation and cause the pleural layers to adhere to each other. This procedure helped in preventing future fluid buildup.

In this situation, the surgeon may report thoracic surgery CPT code 32650. The reason? It most specifically defines the performed procedure. The code covers visually examining the pleura and lungs to perform pleurodesis. It also involves irritating the pleura, either mechanically or chemically, making the layers stick together to prevent fluid accumulation.

CPT Code 32658 – Blood Clot or Foreign Body Removal

The thoracic surgery CPT code 32658 covers visualizing the pericardial sac using an endoscope and removing a foreign body or blood clot. 

Assume a patient with breathing issues and chest pain visited the surgeon. The imaging studies revealed a large blood clot within the pericardial sac. As a result, the thoracic surgeon used an endoscope to visualize the pericardial space and carefully removed the blood clot through the thoracoscope.

CPT Code 32664 – Sympathectomy for Hyperhidrosis

This CPT code for thoracic surgery reports that the healthcare practitioner performed a thoracoscopy to visually examine the lungs and pleura using an endoscope and destroyed the sympathetic nerve trunk portion in the chest area. It is typically performed to treat hyperhidrosis (excessive sweating).

Consider a patient who failed to treat severe hyperhidrosis with conservative treatments, such as medications and antiperspirants, and was referred to a thoracic surgeon as it significantly impacted his quality of life.

The surgeon performed a video-assisted thoracoscopic sympathectomy to visualize the patient’s chest cavity and selectively destroy the sympathetic nerve trunk portion responsible for excessive sweating in the patient’s hands. Here, the practitioner may report thoracic surgery CPT code 32664 to receive rightful reimbursements for the performed services.

CPT Code 32667 – Additional Lung Segment Resection

It covers visualizing the chest cavity and the lung to remove or resect the lung’s additional section where a nodule or mass is located. The provider may perform this thoracic procedure after first resecting another lung section.

Let’s discuss a scenario for more clarity! A patient underwent video-assisted thoracoscopic lobectomy for lung tumor removal. However, the surgeon identified an additional suspicious nodule in a separate lung segment during the procedure. Therefore, the thoracic surgery CPT code 32667 procedure was rendered.

CPT Code 32673 – Thoracoscopic Thymectomy

What if a patient with myasthenia gravis complains about severe fatigue and muscle weakness? The thoracic surgeon may perform video-assisted thymectomy to visualize the thymus gland and proceed to resect the entire left lobe of the thymus. 

So, how would you code the service accurately? The healthcare provider may report 32673 CPT code for thoracic surgery. It covers the removal of the lobes, unilateral or bilateral, after visualizing the chest cavity or the thymus.

Summary

Let’s quickly recap what we discussed in this comprehensive guide related to the thoracic surgery CPT codes list! We explained code descriptors along with relevant examples of several thoracic surgical procedures, including 32096 (lung infiltrate biopsy), 32491 (lung volume reduction surgery), 32604 (pericardial sac biopsy), 32607 (multiple lung nodule resections), 32650 (pleurodesis), 32658 (blood clot or foreign body removal), 32667 (additional lung segment resection), and 32673 (thoracoscopic thymectomy).

We hope this guide will help you navigate the intricate thoracic surgery billing landscape. However, if you still find it challenging to manage it in-house, at MediBillMD, we offer tailored thoracic surgery billing services, helping you achieve the ultimate financial success.