ED Coding and Reimbursement Alert

Question: I heard one of my co-coders talk about a patient suffering a pleural effusion in the ED where she used to work. I-ve never heard of that: What is a pleural effusion and how does the physician treat it? North Carolina Subscriber Answer: A pleural effusion, or an abnormal fluid accumulation between the pleural surfaces, can be caused by lung cancer, pneumonia, lung infections, drug reactions, asbestosis, sarcoidosis, abnormal lung pressure and congestive heart failure. Treatment options: The physician may treat the condition using one of the following methods: - thoracentesis (32000, Thoracentesis, puncture of pleural cavity for aspiration, initial or subsequent; 32002, Thoracentesis with insertion of tube with or without water seal [e.g., for pneumothorax] [separate procedure]); or - chest tube insertion (32020, Tube thoracostomy with or without water seal [e.g., for abscess, hemothorax, empyema] [separate procedure]). Diagnosis options: You-ll report ICD-9 code 511.x (Pleurisy) for most patients with a pleural effusion.