Pulmonology Coding Alert

Question: A thoracic surgeon performs bilateral lung volume reduction. What code should I report? Would I code the same for a when the procedure is performed unilaterally.

Answer: The code for lung volume reduction is 32491 (Removal of lung, other than total pneumonectomy; excision-plication of emphysematous lung[s] [bullous or non-bullous] for lung volume reduction, sternal split or transthoracic approach, with or without any pleural procedure).

Fact: This code is considered unilateral or bilateral. Therefore, you should assign 32491, regardless of whether the thoracic surgeon performs the procedure on one lung or two. You do not need modifier 50 (Bilateral procedure) to indicate a bilateral procedure or modifier 52 (Reduced services) to reflect a unilateral procedure for a code that is considered inherently bilateral.

Answers to You Be the Coder and  Reader Questions reviewed by Alan L. Plummer, MD, professor of medicine, Division of Pulmonary, Allergy, and Critical Care at Emory University School of Medicine in Atlanta; and Carol Pohlig, BSN, RN, CPC, ASC, senior coding and education specialist at the University of Pennsylvania department of medicine in Philadelphia.