General Surgery Coding Alert

Note CMS' surprise 0-day global.

Not only did CPT® 2012 change the heading of its "Thoracoscopy" section to include the term "VATS" (video-assisted thoracic surgery), it also debuted three new diagnostic thoracoscopy codes.

Read on to see how the new codes allow more specific reporting beginning Jan. 1, as well as how you might gain E/M pay for the service.

Specify Lung Biopsy Tissue With New Codes

CPT® 2012 deletes 32602 (Thoracoscopy, diagnostic [separate procedure]; lungs and pleural space, with biopsy) and instructs coders to see the following three new codes to "report lung or pleural space biopsy[ies]":

• 32607 -- Thoracoscopy; with diagnostic biopsy(ies) of lung infiltrate(s) (e.g., wedge, incisional), unilateral
• 32608 -- ...with diagnostic biopsy(ies) of lung nodule(s) or mass(es) (e.g., wedge, incisional), unilateral
• 32609 -- ...with biopsy(ies) of pleura.

Choose the proper code based on whether the biopsy is from lung infiltrate, nodules/masses, or pleura. Do not report 32607 or 32608 more than once per lung, according to CPT® instruction.

Watch global days: Interestingly, these new codes were assigned fewer global days than even the CPT® Advisory Committee suggested.

"Diagnostic thoracoscopies (32607-32609) have zero-day globals," said Francis C. Nichols, III, MD, during his "CPT® Changes: Cardiothoracic Surgery" presentation at the CPT® 2012 Annual Symposium in Chicago. "We actually have in a recommendation to change those to ten-day globals, which would reflect the time the patient spends in the hospital (which can be up to ten days), but that has not yet changed."

Opportunity: As long as the procedures have zero global days, physicians can separately report E/M services that they provide to patients during the related hospital stay, except on the actual day of the procedure itself.