Pleural scarification vs. pleurodesis

[lisigirl]

Can someone explain the difference between codes 32215 and 32560? In both cases, the surgeon is injecting a chemical into the chest cavity for repeat pneumothorax.

Thanks!

Lisi, CPC

 

[LLovett]

That is an excellent question.

In looking at my CVT coding companion, the coding tip under 32560 is

"For treatment of pneumothorax with thoracentesis with insertion of a tube, with or without a water seal, see 32422. for pleural scarification by other methods, see 32215. for thoracoscopy with pleurodesis, see 32650"

The coding tip under 32215 is

"To report chemical pleurodesis for recurrent or persistent pneumothorax, see 32560. Supplies used when providing this procedure may be reported with A7042. Check with the specific payer to determine coverage."

My take on the two is that 32560 is when they get the surface of the lung to adhere to the inside surface of the chest cavity. 32215 is when they just create adhesive scar tissue between the lung and chest cavity, not a complete adhesion of the two surfaces.

Again, that is just my opinion and if that is wrong I hope someone posts the correct answer.

Laura, CPC

 

[lisigirl]

Thanks Laura, you may be onto something. My only thing with what you said is that the RVUs for 32215 are much higher than 32560 (21 vs 3) and in your explanation, I feel like code 32560 sounds like the more difficult procedure (therefore its RVUs should be higher).

I do like your explanation though. I will f/u with my surgeons and see what they think.

Of course, if anyone else has anything to add, I would appreciate it!

Thanks,
Lisi