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I need help before i @##@$%

  1. Default I need help before i @##@$%
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    I know this is probably so easy and I am just second guessing myself but this is the procedure performed as per the op report:

    Video-assisted thoracoscopic surgery on the right side with excision of multiple subpleural blebs as well as a stapling of pleural blebs followed by pleural scarification and placement of intrathoracic talc with insufflator and tube thoracotomy drainage x2.

    I am looking at codes 32655 and 32650 with a 51 mod ... then I look elsewhere and see pleural scarification for repeat pneumothorax is a 32215 and chronic pneumothorax is one of the dx's (512.8). I don't know, I don't get if I must code for the drainage, etc.

    I am in need of some help please.

    Chrissy S.

  2. #2
    Fayetteville, NC
    Is that all the OP note says or is that just the physician's basic description?
    I honestly wouldn't code such a complex procedure without more information.

  3. #3
    Woodbridge, Virginia
    The cpt code that we use is includes any pleural procedure including cpt 32650...if you try using both codes, the cpt 32650 will be denied as bundled w/32655.


  4. Question
    @Grintwig, The description that I wrote was just pulled from the "Procedure Performed" section. There is a full OP report here in front of me.

    @GIBBERS, Yes I think you are right with the 32655 code, as I was leaning towards that myself. My problem is I think I am confused on what codes are bundled-are there any resources to see what codes are bundled besides what would be the obvious?

    In this OP report it states that after the multi blebs excision, pleural scarification was done next followed by the placement of intrathoracic talc with insufflator and tube thoracotomy drainage x2. So how am I to know if CPT code 32215 ( pleural scarification for repeat pneumothorax) isn't to be allowed for use? This patient's DX is repeat pneumothorax (512.8)

    This is just driving me bonkers. Idk what to do, I don't want to under/over code nor do I want to unbundle code sets.

    Thank you Grintwig and GIBBERS, do you both have any other thoughts? Anyone else have any advice?

  5. Default
    I wouldn't code the pleural scarification 32215 because the 32655 states excision-plication of bullae, INCLUDING ANY PLEURAL Procedure...Yikes..Help! LOL

  6. #6
    I too would not code scarfication i believe it is included as a pleural procedure

    Lori Z cpc, ccvtc

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