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Multiple Procedures - Here are the procedures

  1. #1
    Default Multiple Procedures - Here are the procedures
    Medical Coding Books
    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.

  2. Default
    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

  3. #3
    Default
    Lisi, thanks for the explanations, very helpful.

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