# Chest tube placement



## lorrib (Jul 17, 2015)

Hi,

I am having trouble discerning which cpt code to use for a right anterior chest tube placement, second intercostal space.  A lot of the codes seem almost identical, can someone please help?  The diagnosis was:  recurrent pneumothrox

Here is the procedure:  At the patient's bedside, patient was in a 45 degree angle on a nonbreather mask.  Attention was turned to the patient's right chest.  The patient had significant crepitus to the anterior chest wall with extension to the neck along the shoulder and the right biceps area.  Secondary to the recurrent pneumothorax, the patient's chest was prepped and draped in the usual sterile fashion.  I then anesthetized the infraclavicular area with a local anesthetic.  I then palpated for the second intercostal space, made a skin incision in a transverse fashion with a #10 blade scalpel.  With a  Mayo scissors, I dilated through the creptius tissue until I was able to directly palpate the second intercostal space.  I then passed over the superior margin of the 3rd rib a 28 French chet tube with immediate rush of air, I secured the chest tube to the anterior chest wall with0 Prolene and 0 silk interrrupted suture with half-hitch ties.  The chest tube was hooked to the PneumoVac Canister and placed to 20 cm H2O with wall suction, sterile dressing was applied.  

I was wondering if this should be 32551, 32554, or 32556 but no needle was mentioned nor was a trocare mentioned.

Thank you ,
Lori


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## nlmxray1 (Jul 17, 2015)

From what I'm reading it's a 32551, a straight Chest Tube insertion and PneumoVac to re-inflate the lung.  Definitely not a 32556 which has to be a tunneled cath which I don't see evidence of.  The 32554 is a thoracentesis, so it's not that either.  It involves only a needle insert to drain off the pleural effusion and then taking the needle out, no tube/cath left in the chest.  Hope this helps.


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## lorrib (Jul 21, 2015)

*Chest tube*

Thank you for your help.  I did think it should be 32551 but wasn't entirely sure.  
I really appreciate your quick reply.


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