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thoracentesis coding

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When do you use 32422 thoracentesis with insertion of tube vs 32551 tube thoracostomy. Don't do a lot of these and the descriptions sound so much alike. Could someone give me a good explanation for when to use.


True Blue
Richardson, TX
Best answers
I only bill 32551 if the only thing done was placing a chest tube (it's usually included within other procedures) but there are times, though few and far between, where I bill for 32551.

So, while 32551 includes ONLY the chest tube, 32422 is a thoracentesis WITH chest tube insertion. If the physician did not perform thoracentesis, then only bill for the chest tube 32551. If the physician performed throracentesis with chest tube...32422.

Thoracentesis is when the physician inserts a trocar or needle over the ribs and punctures the chest tissue between ribs, and enters the pleural cavity. Then advancing the needle, a syringe is attached to the outside of the catheter and fluid is removed from the chest cavity. The chest tube allows for continuous or intermittent removal of fluid.