# Thoracotomy and decortication



## CRC CPC (Jun 29, 2010)

Please help vats converted to open thoracotomy, Extensive decortication of right lower, middle and upper lobes with thick rind 2-3mm thick.  The lung was completely trapped it took 2 1/2 hours for decortication. Pleurodesis and Left chest tube for pleural effusion.
The codes I come up with for these procedures are inclusive to each other.   Also per the op report he does extensive decortication on the right lung does this qualify for total or is it concidered partial as it is only the right lung?
Thank you in advance for any help.


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## lisammy (Jul 1, 2010)

I would use 32220 for a total decortication. Extensive to me means they removed the entire llung surface was removed.


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## CRC CPC (Jul 1, 2010)

Thank you Thank you Thank you.  I just wanted to be sure...


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## preserene (Jul 9, 2010)

I agree with that being "extensive'. More than the term 'extensive'  being given importance here in this case, don't we find that the notes provided, gives you that the "lower, middle and upper lobes of the right" Lung
itself denotes the total right lung-the three lobed;anyway the code is32220.

 My question to you: Is the pleurodesis of the left lung bundled with the major operative procedure of the right lung.
 I do understand that the placement of the catheter/tube is  not to be separately coded when a major operative surgery is done. Is this applicable only to the same side of procedure or also to the placement and -desis of the other side.
Am I to take it for granted that full thorocotomy being necessary, all these bundled into one? 

wont we append the code 32560 here becuase this -desis is co-surgical procedure?  

Is there a place for a modifier in your case


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