Pulmonology Coding Alert

Question: My pulmonologist inserted a chest tube and then instilled a fibrinolytic agent to break up multiloculations to free up an entrapped lung. Usually, I use 32560 for this procedure, which is for pleurodesis, not fibrinolysis. What code should I use for fibrinolytic agent instillation? Illinois Subscriber Answer: Starting Jan. 1, you will be able to use one of two new fibrinolytic agent instillation codes depending on the treatment day: • For instillation on the initial day, use 32561 (Instillation[ s], via chest tube/catheter, agent for fibrinolysis [e.g., fibrinolytic agent for breakup of multiloculated effusion]; initial day). • If the pulmonologist instills the fibrinolytic agent on a subsequent day, assign 32562 (... subsequent day). Rule: Always report each day's code only once. Instillation, however, may occur multiple times per day over the course of several days. Currently, you have to code fibrinolysis as an unlisted procedure using 32999 (Unlisted procedure, [...]