Pulmonology Coding Alert

Misunderstanding physician's notes can cost your practice $38 per procedure.

Don't shortchange your practice when reporting thoracentesis by picking the wrong code. When your pulmonologist performs this procedure you either use 32421 or32422 to report your claims. But it's not as easy as 1-2-3. Take this quiz and compare your answers with the solutions provided in a related article.

Test yourself with these two scenarios

Scenario 1: A patient comes to the office complaining of shortness of breath. The pulmonologist evaluates the patient obtaining important historical information. She then performs an exam, including percussion and auscultation of the lungs.

She percusses the patient's chest, noting dullness. The breath sounds are greatly diminished over the area where the chest dullness was found. After a chest x-ray, she confirms the presence of a pleural effusion.

Based on the x-ray results, the pulmonologist decides to sample the patient's pleural fluid using a needle attached to a syringe. He then sends the fluid to the laboratory for analysis. The results indicate the presence of an exudative pleural effusion. What should you report?

Scenario 2: A patient with malignant effusion due to lung cancer requires a thoracentesis to help relieve dyspnea (786.0x). During the procedure, the pulmonologist inserts a catheter over a needle into the pleural cavity, withdraws the needle, and drains the pleural fluid. The catheter remains in place until the procedure is over. What should you report? Turn to page 45 to see if you got the answers right.