32505 vs 32500

rceron

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hi i have a question in reference with cpt 32505 as you know this procedure is replacing 32500. my doctor used to bill 32500 along with the removal lymp nodules 38746; my question is someboy know if 32505-32507 includes this removal? description mention mass or nodules but is not that clear for me.
 

Michelle Thompson

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Central Philadelphia chapter
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For the Lymph node removal you would still use +38746. Look at the note under 38746- report in conjunction with ... - code 32505 is there.
I have simular issue but I need the VATS lymphadenectomy +32674 and the note under 32674 report in conjunction with ...- does not include my primary code 32607.
 

lisigirl

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Michelle,

is your surgeon just taking a biopsy of lung infiltrates (32607) and doing a lymphadectomy? Because if the patient has a lung nodule rather than infiltrates, the argument can be made that removing the nodule is for diagnosis and treatment. If performed for treatment, you can bill with 32666 which is listed as a primary code for 32674.

My guess is that 32607 is not listed as a primary code because why would the surgeon remove all those nodes (remember, they must remove all the nodes listed to bill 32674) if they were only doing doing a diagnostic biopsy of an infiltrate?? Of course, there isn't always a method to this madness :)

Lisi, CPC
eharkler@nmh.org
 
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