Question: Arkansas Subscriber Answer: You would only use new code 32552 (Removal of indwelling tunneled pleural catheter with cuff) if your surgeon removes a special kind of chest tube that is tunneled under the skin. If the physician removes a tunneled catheter and replaces it with a new tunneled catheter, you should bill both 32552 for the removal and 32550 (Insertion of indwelling tunneled pleural catheter with cuff) for the placement. If the physician removes a tunneled catheter and replaces it in the same location with a non-tunneled chest tube (32551, Tube thoracostomy, includes water seal [e.g., for abscess, hemothorax, empyema], when performed [separate procedure]), you can't bill for both services. CPT "separate procedure" designation means that 32551 is an "integral component" of other procedures at that site. Exception: