# Tube Thoracostomy vs. Pleural Drainage



## Nancy R Parent (Dec 21, 2012)

In 2013, we are going to have 4 new codes to replace 32421 (Thoracentesis).  The codes 32556 & 32557 (Pleural Drainage w & w/o imaging), sound very similar to Tube thoracostomy (32551) code, except there is the insert of indwelling catheter.  I haven't been able to find a good description of the new codes yet, beyond the CPT description.  Do you think the 32556 or 32557 will be procedures performed in the ER?  If not, I'm not going to set them up on our screens for the docs to choose.


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## donnajrichmond (Dec 27, 2012)

parena5 said:


> In 2013, we are going to have 4 new codes to replace 32421 (Thoracentesis).  The codes 32556 & 32557 (Pleural Drainage w & w/o imaging), sound very similar to Tube thoracostomy (32551) code, except there is the insert of indwelling catheter.  I haven't been able to find a good description of the new codes yet, beyond the CPT description.  Do you think the 32556 or 32557 will be procedures performed in the ER?  If not, I'm not going to set them up on our screens for the docs to choose.



In 2013, 32551 is an open procedure (cut-down for example), 
32554 (no guidance) and 32555 (imaging guidance) are for use for a percutaneous needle or catheter to aspirate whatever out of the pleural space, but then remove the catheter/needle before the patient leaves or is admitted.  If you coded 32421 or 32422 (with or without guidance codes) before you would use 32554 or 32555 in 2013. 
32556 (no guidance) and 32557 (imaging guidance) will be used when a catheter is placed percutaneously and left in (but not tunneled).  If you coded 32551 (75989) before, you will code 32556 or 32557 in 2013.


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## Nancy R Parent (Dec 28, 2012)

Donna, thank you for your response!  It makes it much clearer.  Do you have a reference you used for your reply?  Thank you again.  If you need to explain further, you could send to:  nparent@cmc-nh.org, or 603-663-5309.  Nancy


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