32421
32551
75989-26
76942-2659
I have the above codes for the following procedure.Can we code 32551 for thoracostomy tube placement or can we code 32422 combining 32421 & 32551?
Ultrasound Thoracentesis and Thoracostomy Tube Placement:
66-year-old male status post
laryngopharyngectomy, esophagectomy with gastric pull up with
recurrent bilateral pleural effusions and episodes of desaturation
during. Patient referred for image guided thoracentesis and
thoracostomy tube placement.
Initial US images demonstrated a large right-sided loculated
pleural effusion.
The posteriolateral left chest wall was then prepped and draped in
the usual sterile fashion. After the administration of local
anesthesia and under US guidance, access into the pleural effusion
was obtained with an 18 gauge needle. Several cc's of
serosanguinous fluid was aspirated. Samples were sent for culture
and sensitivity, cytology, cell count and chemistry levels.
An Amplatz wire was advanced through the needle and coiled within
the collection. The needle was removed and serial dilatation of
the tract was performed. An 8 French multi-sidehole pigtail
drainage catheter was then advanced over the wire and positioned
with its distal pigtail coiled within the pleural effusion.
Approximately 300 cc of serosanguinous fluid was then aspirated.
After which, repeat ultrasound images demonstrated marked residual
fluid within the left pleural space.
Repeat US images confirmed good positioning of the distal pigtail
within the loculated pleural effusion and demonstrated residual
fluid within the left pleural space.
It was decided to maintain the thoracostomy tube for
further drainage.
The catheter was secured to the skin with 2 0 prolene suture. The
catheter was flushed with 10 cc of normal saline and attached to
Pleurovac drainage. A sterile dressing was applied over the skin
entry site.
32551
75989-26
76942-2659
I have the above codes for the following procedure.Can we code 32551 for thoracostomy tube placement or can we code 32422 combining 32421 & 32551?
Ultrasound Thoracentesis and Thoracostomy Tube Placement:
66-year-old male status post
laryngopharyngectomy, esophagectomy with gastric pull up with
recurrent bilateral pleural effusions and episodes of desaturation
during. Patient referred for image guided thoracentesis and
thoracostomy tube placement.
Initial US images demonstrated a large right-sided loculated
pleural effusion.
The posteriolateral left chest wall was then prepped and draped in
the usual sterile fashion. After the administration of local
anesthesia and under US guidance, access into the pleural effusion
was obtained with an 18 gauge needle. Several cc's of
serosanguinous fluid was aspirated. Samples were sent for culture
and sensitivity, cytology, cell count and chemistry levels.
An Amplatz wire was advanced through the needle and coiled within
the collection. The needle was removed and serial dilatation of
the tract was performed. An 8 French multi-sidehole pigtail
drainage catheter was then advanced over the wire and positioned
with its distal pigtail coiled within the pleural effusion.
Approximately 300 cc of serosanguinous fluid was then aspirated.
After which, repeat ultrasound images demonstrated marked residual
fluid within the left pleural space.
Repeat US images confirmed good positioning of the distal pigtail
within the loculated pleural effusion and demonstrated residual
fluid within the left pleural space.
It was decided to maintain the thoracostomy tube for
further drainage.
The catheter was secured to the skin with 2 0 prolene suture. The
catheter was flushed with 10 cc of normal saline and attached to
Pleurovac drainage. A sterile dressing was applied over the skin
entry site.