Anesthesia Coding Alert
VATS Code Hinges on 1-Lung Ventilation
Question: The patient's chart states, "VATS procedure with pleurodesis." What is VATS, and what anesthesia code applies? Answer: VATS is "video-assisted thoracoscopy," which is surgical code 32650 (Thoracoscopy, surgical; with pleurodesis).
New York Subscriber
Your anesthesia code will depend on whether the physician used one-lung ventilation during the procedure.
If so, you'll report 00541 (Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum [including surgical thoracoscopy]; utilizing one-lung ventilation). If the anesthesiologist does not use one-lung ventilation, report 00542 (... decortication) instead.
Some coders consider reporting 00528 (Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy not utilizing one-lung ventilation) or 00529 (... mediastinoscopy and diagnostic thoracoscopy utilizing one-lung ventilation) for this type of procedure. Codes 00541 and 00542 are better choices, however, because they represent surgical rather than diagnostic procedures.
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