Pulmonology Coding Alert

Question: Our pulmonologist recently performed right-sided chemical pleurodesis with doxycycline on a patient suffering from pleural effusion. Is there a code to report this procedure?

Maryland Subscriber

Answer: Pleurodesis is a procedure that your pulmonologist will perform to obliterate the pleural space by instilling some chemicals such as bleomycin, doxycycline, povidone iodine, tetracycline or talc through a chest drain. These chemicals will irritate the parietal and the visceral pleurae and brings them together thus preventing any more fluid from accumulating in the pleural space. Your pulmonologist will usually use this procedure to prevent recurrence of conditions in which there is fluid or air accumulation in the pleural space.

When your pulmonologist performs pleurodesis, you will have to report the procedure using the CPT^® code 32560 (Instillation, via chest tube/catheter, agent for pleurodesis [e.g., talc for recurrent or persistent pneumothorax]). You will have to report placement of the chest drains that is used to carry the chemical used for the pleurodesis with the CPT^® code 32550.

If your pulmonologist performs the procedure as part of a video assisted surgical thoracoscopy, you will have to report the procedure using 32650 (Thoracoscopy, surgical; with pleurodesis [eg, mechanical or chemical]).