ED Coding and Reimbursement Alert

Question: A 50-year-old male patient is brought to the ED via ambulance; the emergency medical technician (EMT) tells the physician that the patient was mostly complaining of right-sided chest pain during the ride to the hospital; the physician provides a levelfive E/M service while stabilizing the patient; during the E/M, the physician discovers that the patient has been experiencing shortness of breath for a month, a moderate cough for the past three weeks, and occasional night sweats. A two-view chest X-ray reveals a moderate right pleural effusion. The physician performs thoracentesis, which reveals gross purulent material; the physician uses a needle and catheter tube to drain the fluid from the patient's chest cavity. Since the physician's procedure was more  extensive than simply inserting a needle, what code should be assigned?Minnesota SubscriberAnswer: In your scenario, the physician performed therapeutic thoracentesis. On the claim, report the following:32422 (Thoracentesis with insertion of tube, [...]