Wiki imaging guidance vs ultrasound guidance

[trwhernandez]

I will be sitting for my CPC on Aug 19. This question is from case 1 practice exam. The rationale states 32557 is the answer. In the CPT book, 32557 directs you to use 32550 if an indwelling tunneled plueral catheter is used. Shouldn't the answer then be D and not A?

Question 8
A CT scan identified moderate-sized right pleural effusion in a 50 year-old male. This was estimated to be 800 cc in size and had an appearance of fluid on the CT Scan. A needle is used to puncture through the chest tissues and enter the pleural cavity to insert a guidewire under ultrasound guidance. A pigtail catheter is then inserted at the length of the guidewire and secured by stitches. The catheter will remain in the chest and is connected to drainage system to drain the accumulated fluid. The CPT® code is:
A. 32557
B. 32555
C. 32556
D. 32550

 

[CodingKing]

I cant see the rationale but the word tunneled is not mentioned in the scenario. needle was directly entered into the pleural space. Tunneled there were be mention of creating a subcutaneous tunnel to get to the pleural space