Wiki Multiple Procedures - Here are the procedures

[jreavis]

Here are the procedures done on a patient
Flexible bronchoscopy
Cerival mediastinoscopy with biopsy of lymph nodes from stations 4 and 7
Left thoracotomy
Left pneumonectomy
Sampling of lymph nodes from stations 5,6,and 8
Drainage of pericardial effusions

I am coming up with
32440
33025
32095
39400
38746
31622

Any guidance would be appreciated.

 

[lisigirl]

Hi,

I don't have my CPT in front of me so I may be a little off with codes. I definitely agree with the following:

32440 - pneumonectomy
39400 - mediastinoscopy
and I think 33025 (drainage of effusion) - but you should make sure this does not bundle.

As for 32095, that is the thoracotomy, correct? That bundles into 32440. You cannot perform a pneumonectomy without gaining access to the chest so that is included.

As for 38746, the Society of Thoracic Surgeons has stated that at a minimum, all nodes from levels 4,7 and 9 should be removed to bill with this code. If nodes from 5,6 & 8 were only sampled, I would not bill separately for this.

I would not bill 31622 because a diagnostic bronchoscopy is considered a separate procedure and should not be billed in conjunction with a lung resection.

Hope this helps.

Lisi, CPC
eharkler@nmh.org

 

[jreavis]

Lisi, thanks for the explanations, very helpful.