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.
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